You will focus largely on supporting the development of novel reimbursement policies, analysis to identify erroneous payments, and specific management programs to manage medical cost.
You will play a vital role in the translation of clinical and reimbursement concepts into medical codes which will be the foundation of our analytics. You will asked to translate clinical concepts into medical codes (ICD-9, ICD-10, CPT-I, CPT-II, HCPCS, DRGs) and convert clinical concepts documented in ICD-9 to ICD-10 and vice versa, if required.
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You will be expected to maintain code lists that represent critical clinical concepts (e.g., update code lists based on latest introduction or removal of specific codes) and act as a thought partner in understanding how physician’s offices, hospitals, and payors approach billing of various procedures and diseases
QUALIFICATIONS
Undergraduate degree in healthcare management, healthcare informatics, human biology, economics, or other related fields We will also consider candidates with an associate’s degree and significant experience working as a medical coder Certified as Coding Associate Certification (CAA), or equivalent 5+ years of experience working as a medical coder Passion for collaborating with others to identify disease concepts through medical codes and using the medical coding data in novel ways Experience in preparing for transition to ICD-10 Experience maintaining code lists and using data management tools such as Excel, Tableau, and other is highly preferred Strong problem solver with ability to research and frame answers to ambiguous coding questions Self-starter able to work independently and deliver quality end-products in an entrepreneurial environment Detail-orientedOf mature disposition and personable; history of working as a team player in a dynamic and changing environment Able to work well within teams across continents/time zones Good oral and written communication skills
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