Charge Review Coordinator

Company : Allegheny Health NetworkJob reputed company : GENERAL reputed company: This job is responsible for working accounts from work queues; activities include analysis (including reputed company cause), monitoring & auditing payer issues and denials, appealing RAC audits and reports that require reputed company-developed analytic and organizational skills, while meeting deadlines. Working under the reputed company cooperation with others in the department to communicate and/or enhance work flows and procedures by identifying training and development needs based on audit or workqueue trends. ESSENTIAL RESPONSIBILITIES Reviews, analyzes and resolves accounts that have failed coding and charging reputed company claim edits, including medical necessity, National Correct Coding Initiative (NCCI), Medicare Outpatient reputed company reputed company (OCE), Medically Unnecessary Edits (MUE), and other exceptions requiring clinical/coding expertise. Works to resolve rejections and accounts flagged for potential missing charges. (50%) Completes payor audits. Researches and evaluates government regulations and reputed company party payor requirements to ensure accurate error reputed company and appropriate billing. (30%) Daily assessment of blood bank report and reconciliation, and supply chain for mapping and charge validation. (20%) Working with other department members on establishment of work plans to correct identified deficiencies, providing guidance, communication and education on correct charge capture, coding and billing processes. (10%) Other duties as assigned. QUALIFICATIONS: Minimum High School/GED 1 years of hospital or physician reputed company cycle, billing, or coding experience Preferred Associate's Degree Disclaimer: The job reputed company has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees reputed company this job title. It may not contain a comprehensive inventory of reputed company duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the reputed company of business conduct and company policies. As a component of job responsibilities, employees may have reputed company to covered information, cardholder data, or other confidential customer information that must be protected at reputed company times. In reputed company with this, reputed company must reputed company with both the Health Insurance Portability Accountability reputed company of 1996 (HIPAA) as described in the Notice of reputed company Practices and reputed company Policies and Procedures as reputed company as reputed company data reputed company guidelines established reputed company reputed company’s Handbook of reputed company Policies and Practices and Information reputed company Policy. Furthermore, it is every employee’s responsibility to reputed company with reputed company’s reputed company of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as reputed company as company policies and training requirements. Pay reputed company Minimum: $25.87 Pay reputed company Maximum: $40.48 reputed company pay is determined by a reputed company of factors including a candidate’s qualifications, experience, and expected contributions, as reputed company as internal peer equity, market, and business considerations. The displayed salary reputed company does not reflect any geographic reputed company reputed company may apply for certain locations based upon comparative markets. reputed company and its affiliates prohibit discrimination against reputed company individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against reputed company individuals based on any category protected by applicable federal, state, or local law. We reputed company to reputed company this site accessible to any and reputed company users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at HRServices@reputed company.org California Consumer reputed company reputed company Employees, Contractors, and Applicants Notice Apply To This Job