Review
and analyze pre
and post pay complex
health care claims from a medical perspective: Review provider practices
and identify issues of concern, overpayment…
Identify incomplete
or conflicting documentation in the medical record
and formulate a physician query to obtain missing documentation
and/
or clarification to…
Completion of college level courses
or relevant experience in anatomy
and physiology
and medical terminology required. High School Diploma
or GED.
Ability to tolerate prolonged periods of sitting,
or standing and/or walking. Establishes
and maintains working relationships with surgeons,
nursing, case…
Employees may interact with upset staff and/or public
and private representatives in interpreting
and enforcing departmental policies
and procedures.
Employees may interact with upset staff and/or public
and private representatives in interpreting
and enforcing departmental policies
and procedures.
Attend clinical staff meetings either in person
or online
and participate in the development
and review of patient care guidelines
and standards as assigned.
Employees may interact with upset staff and/or public
and private representatives in interpreting
and enforcing departmental policies
and procedures.
Ensures compliance with all applicable Federal, State, and/or County laws
and regulations related to coding
and documentation guidelines for Risk Adjustment.
Identifies need for OASIS/documentation education
and communicates group needs to care center leadership
and Supervisor. HCSD
or BCHH-C ICD-10 certification.
Employees may interact with upset staff and/or public
and private representatives in interpreting
and enforcing departmental policies
and procedures.
Responsibilities include supervising
and evaluating staff; managing
and coordinating the budget; advocating for policies
and a built environment that address…