1. Follows department established Fax Review protocols. Extracts and summarizes pertinent clinical information to transmit to payors for reimbursement. 2. Proactively identifies potential concerns regarding clinical eligibility for admission and/or continued stay reviews and addresses with Care Coordination. 3. Coordinates reconsiderations and/or peer to peer reviews for

1. Screens and refers incoming phone calls and directs patients and families to ensure that accurate and timely department communication is facilitated and that the Department is represented in a positive manner. 1.1 Provides all support and clerical assistance to patients, families, staff (both departmental and hospital), and community contacts with the greatest consider

1. Assisting in the ongoing updates of CPT and ICD10 Notifying physicians of changes within each specialty; evaluating procedure codes and diagnosis on an ongoing basis and recommending corrections and changes for continuous improvement; Reviewing coding guidelines for OP reports, Multi Specialty Surgeons, Physician Assistants, hospitalists and other departments; attendin

1. Reviews medical record documentation to determine appropriate ICD 10 CM codes in accordance with official coding guidelines. 2. Reviews medical record documentation and accurately selects the appropriate CPT codes, modifiers, and ICD 10 PCS, when applicable, in accordance with official coding guidelines. This includes resolving CCI edits, as applicable. 3. Maintains a

1. Accurately prepares patient documentation for batch scanning into electronic record system. 1.1 Prepares patient documentation for scanning according to the date of discharge, or other criteria communicated by department leaders. 2. Scans documents into electronic document management system using a batch scanner. 2.1 Operates batch management software and batch scanner

1. Analyze and document all problems and resolutions to HVC Procedural services charging process 2. Develops and maintains a working knowledge of CPT coding, ICD 9/10 coding, DRG's and revenue contracts to ensure proper and effective charge capture is accomplished in HVC Procedural Services. 3. Develops working knowledge of all standard Hospital software products related

1. Researches payer denials related to medical necessity, coding, etc resulting in denials and delays in payment. 2. Evaluates Outpatient Clinical denials against medical record documentation, the coding of the encounter , payer policies and contracts, and coverage determinations to determine the viability of an appeal 3. Compiles the supporting documentation by working i

1. Manages in collaboration with the OP Coding Leadership team the day to day activities related to Outpatient Coding AR to ensure accuracy, completeness, and timeliness of coding completion. This includes, but is not limited to ongoing communication and collaboration with internal and partner departments to resolve outstanding issues and streamline workflows, monitoring

1. Collects, validates and accurately documents patient insurance and benefits information and is fully knowledgeable about all aspects of insurance verification requirements. 1.1 Utilizes the On line Eligibility system and/or other means (i.e. telephone, fax or various third party payer website) to obtain insurance benefits and makes sure insurance verification informati

Job Description PT 22.5 11a 7p Facilitates the registration of Outpatient Patients. Interviews patient and/or representatives to obtain identifying information and other data required for registration Job Responsibility 1. Receives in coming telephone calls promptly and professionally. 2. Maintains constant awareness of patient arrival. 3. Monitors prescriptions for expir

Coordinates with clinical and clerical staff to obtain charge information for all patients. Processes claims for payment from clinician encounters or insurance forms. Prepare and submit claims to insurance companies/state for reimbursement. Reviews and corrects claims that are missing information according to applicable standards and compliance guidelines. Provides a high

The Medical Compliance Specialist assist with ensuring that the clinical needs of individuals served are being met and maintained as per all state and federal regulations and in accordance with agency policy. This person will support new and existing Managers/Directors by completing regular audits of medical and other records to ensure compliance and assisting with the ne

At Stony Brook Medicine, our Patient Access Representatives are responsible for completing varied, diverse and specialized duties to support the Revenue Cycle, Compliance and Patient Experience by accurately and efficiently completing tasks in areas of Registration, Financial screening and verification, and Patient throughput. Qualified candidates will demonstrate excelle

nGenesis is currently seeking a temporary Data Entry Specialist to work with our client in Wassaic, NY. In this role, you will be working in the NYS Office for People With Developmental Disabilities Taconic office. Apply today and we'll reach out to answer any questions you may have! Job Duties Duties will be performed within the Business Office. Filing, phones, receiving

Provides education to medical providers as warranted. Description What You'll Do Communicates/educates providers on issues such as Medicare coverage, utilization statistics, documentation and medical review by use of written advisories, reports, letters, and telephone contacts. Documents all provider contacts/communications in provider tracking system. Conducts formal con