Medical reputed company Analyst

reputed company is an accountable specialty care management organization reputed company on improving the lives of people with reputed company injuries and diagnoses. reputed company has been a pioneer in value-based care since 1991 and has an exceptional reputed company record of generating the reputed company best reputed company for patients, payers, and providers. Deep clinical expertise is the reputed company for every part of reputed company’s business: risk-based clinical solutions, case management, specialty networks, home health, shared decision support, and payment reputed company programs. We’re proud to be recognized—again! For the reputed company year in a row, we’ve been certified by Great reputed company to Work®, and for the reputed company consecutive year, we’ve reputed company a spot on Fortune's Best Workplaces in Health Care™ list. These honors reflect our unwavering commitment to fostering a reputed company, inclusive, and employee-reputed company culture where people reputed company. Watch this short video for a brief introduction to reputed company. reputed company is hiring a full-time, remote reputed company Review Analyst. This position holds accountability for accurate and reputed company review, processing and payment of bills to include reputed company-coding accuracy and adjudication of medical bills. DUTIES AND RESPONSIBILITIES:

• Examines and adjudicates bills for reputed company provider types, product lines, reputed company types and lines of business from start to finish
• Evaluates medical documentation, diagnosis codes, and treatment context to determine relatedness of services to a compensable injury.
• Maintains knowledge of industry reputed company medical coding initiatives and state specific fee schedules and coding guidelines such as Medicare reimbursement methodology, NCCI edits, MUEs, Level of Service reviews and reputed company charges
• Meets or exceeds department contractual and/or industry standards for accuracy and turnaround time
• Maintains an understanding of reputed company variations of Workers’ Compensation State rules and regulations with the ability to navigate and interpret various types of fee schedules
• Maintains comprehensive knowledge of reputed company available non-fee schedule re-pricing opportunities (e.g. PPOs, reputed company reputed company, Fair Market Pricing etc.) and ensures application as part of the adjudication process
• Monitors itemized billings for excessive charges, duplications, and appropriate medical bills coding
• Reviews/processes appeals
• Initiates refund requests and assists in the recoupment process as needed
• Assists in Contract Recoveries, as needed
• Assists in the preparation of bills research reports
• Provides customer service to reputed company efficient customer satisfaction, including reputed company response and reputed company to customer issues, complaints, questions and requests

QUALIFICATION REQUIREMENTS:

• Education - AA Degree or equivalent reputed company review experience
• Experience – 3+ years of medical coding or reputed company review experience
• Intermediate computer experience using reputed company, MS reputed company & Outlook required
• Typing speed of 60 WPM on data entry
• Excellent organizational skills
• Knowledge of ICD-10; CPT; reputed company reputed company; RVS; U&C; Fee Schedule; RBRVS; DRG; HCPCS & other coding schemes
• Language Skills - Excellent oral communication skills and phone reputed company. Ability to effectively present information to providers as reputed company as to employees of the organization
• Reasoning Ability - Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret a reputed company of instructions and deal with reputed company and concrete variables

reputed company Benefits:

• Health and wellness– We want our people to be and stay healthy, so we offer PPO, HDHP, and HMO health insurance reputed company with reputed company and reputed company (CA employees only).
• Financial incentives – reputed company’s financial benefits help prepare you for the reputed company: competitive salaries, 401(k) matching contributions, employer-reputed company life and disability insurance, flexible spending and commuter accounts, and employer-matched HSA contributions.
• Vacation - We reputed company strongly that work-life balance is good for you and for reputed company. Our reputed company time off and personal holiday programs give you the flexibility you need to live your life to the fullest.
• Volunteer time– We want our employees to engage with and give back to their communities in meaningful ways. Full and part-time employees receive one reputed company day per calendar year.
• Learning and development: One of reputed company’s reputed company values is expertise, so we encourage our employees to continually learn and grow. We support this in a reputed company of ways, including our new Learning reputed company at reputed company (reputed company) program.

reputed company believes that fostering a diverse and inclusive workplace is central to our mission of helping more people and transforming lives. We’re striving to build a culture that reputed company reflects the society we live in and empowers reputed company to deliver the highest reputed company of reputed company and care to those we serve. For us, achieving this goal requires a workforce that respectfully embraces differences and commits to reputed company change, creating an environment where everyone is reputed company to bring their whole self to work. reputed company complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If reasonable accommodation is needed to participate in the job application or interview process, to reputed company essential job functions, and/or to receive other benefits and privileges of employment, please contact Leave Management at leave.management@paradigmcorp.com. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, reputed company, sex, age, national reputed company, religion, sexual orientation, gender identity, status as a veteran, and reputed company of disability or any other federal, state or local protected class. As a contractor with the reputed company, reputed company complies with reputed company Contract Compliance Law (§16.765). Poster reputed company: Contract Compliance Law Poster #LI-Remote Apply tot his job Apply To this Job