Identify appropriate assignment of CPT and ICD 10 Codes for outpatient ancillary services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity Edits Understand the Medicare Ambulatory Payment Classification (APC) codes Abstract additional

Identify appropriate assignment of CPT and ICD 10 Codes for outpatient Emergency Room Department services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility Expert knowledge in ProFee coding specialties; Evaluation & Management, Emergency Room Apply coding knowledge to analyze/correct CCI Edits and Medical Ne

Identify appropriate assignment of CPT and ICD 10 Codes for outpatient ancillary services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity Edits Understand the Medicare Ambulatory Payment Classification (APC) codes Abstract additional

Designing, building and operating secure cloud platform services and software that meet business requirements Leading a team of cloud platform engineers to ensure technical solutions align with architectural principles, design patterns, and security requirements Innovate to improving efficiency, reducing technical drag, and create usable app patterns Practice SRE principl

Provide presentations and demonstrations to customers and prospects of our products after thorough discovery incorporating value statements and benefits to Physicians, Administrators, Clinical Staff and C Level Executives Provide staffing and participation in product areas for tradeshows and product fairs Strategize with the Sales Team on a strategy to win Provide trainin

Review comprehensive diagnostic evaluations to ensure valid diagnosis has been given Obtain clinical information from providers on Applied Behavior Analysis requests for treatment Determine if additional clinical treatment sessions for Applied Behavior Analysis are medically necessary in accordance with appropriate level of care guidelines Manage outpatient cases througho

Act as client lead on a day to day basis for delivery of large scale and complex projects Lead recurring meetings across finance, pharmacy, clinical, and actuarial client teams Collaborate with key stakeholders to identify and develop business questions for analytic investigation (e.g., utilization analysis) Develop and design complex data programs and forecast models, by

Ensures charges are captured in an appropriate and timely manner. Reviews, calculates, and enters charges in the electronic medical record (EMR). Examines financial reports for accuracy edits. Processes and completes charge entry. Ensures charges are compliant with federal regulations. May assist with audits. Manage the intake of members or the admission/discharge informa

Ensures functions performed in accordance with system wide policies, procedures, and governing organizations Defines individual and team goals Monitors staff and department performance and productivity levels and proposes ways to improve effectiveness, efficiency, and productivity Analyzes and identifies problem areas and adjust processes and staffing priorities Collabora

Responsible for greeting and welcoming patients in person. Provides a standard registration process by collecting demographic and financial data and enter information into an electronic medical record. Primary Responsibilities Greets and welcomes patient in person Collects demographic and insurance information Checks in or interviews patient to complete appropriate paperw

Conduct in home assessments including an evaluation of past medical history, review of systems, medication reconciliation, vital signs, and comprehensive physical exam Perform evidence based practice screenings including point of care testing (as appropriate) Identify diagnoses to be used in care management and active medical management in the furtherance of treatment For

Conduct in home assessments including an evaluation of past medical history, review of systems, medication reconciliation, vital signs, and comprehensive physical exam Perform evidence based practice screenings including point of care testing (as appropriate) Identify diagnoses to be used in care management and active medical management in the furtherance of treatment For

Oversight for overall MPP OPAS performance and achievement of contractual SLA goals Facilitate workflow for centralized resources, clinical & non clinical, who engage with onsite client clinical staff to deliver a streamlined UM process flow and best in class client experience for each individual MPP Lead and drive new Integrated Utilization Management and UM component of

Develops complex operational and project related reports including analysis, design, documentation, versioning development, configuration, testing, implementation and ongoing support for Epic Clarity based reporting Receives and documents formal requests from customer including specifications (layout, calculations, data source, etc.) Evaluates requests for completeness an

Understand edits and appropriate department procedures to effectively submit and/or correct errors on claims to the production standards of the department Utilize various resources such as third party publications, procedure manuals and participating contractual agreements, etc. to reconcile accounts Advanced knowledge and understanding to process third party rejections u