Cpc Salary at Craft Recordings BETA

Your Role The Facility Compliance Review team reviews post service prepayment facility claims for contract compliance, industry billing standards, medical necessity and hospital acquired conditions/never events.. The Utilization Management Nurse, Senior will report to the Senior Manager, Facility Compliance Review. In this role you will be reviewing medical documents and applying clinical criteria to establish the most appropriate level of care. Also, you will be reviewing hospital itemized bills for a comprehensive line-by-line audit and manual claims processing on exceptions to ensure that appropriate billing practices are followed based on facility specific contract language. These exceptions may include medical necessity, DRG validation, stop loss, trauma, ER, burns, implants, NICU, transplants, hospital acquired conditions/never events and aberrant billing. Your Work In this role, you will: Perform retrospective utilization reviews and first level determination approvals for membe

Job Description Job Details On Site Clinical Documentation Manager for a large healthcare system in Orange, CA Full Time Permanent Position Highly Competitive Salary Excellent Benefits Job Summary The Clinical Documentation Manager is responsible for the leadership and management of the Clinical Documentation Improvement (CDI) Program. This position is accountable for budgeting, planning and monitoring budget variances, etc. Ensures standards of unit operations are in compliance with all state and federal healthcare regulatory agencies ACDIS & AHIMA guidelines for compliant query, as well as hospital policies and procedures. Incumbent facilitates the improvement in the overall quality, completeness, and accuracy of medical record documentation through comprehensive review and evaluation of the medical record. Proactively seeks clarification from physicians and other healthcare providers when further specificity is needed to ensure. The CDI Manager educates senior leaders and physicians

Job Description Job Description South Los Angeles based FQHC looking for onsite Certified HCC coder . *This is not a remote position Conduct the necessary audits of medical record to verify the physicians have appropriately documented the diagnoses then code these diagnoses in ICD-10 for Medicare Risk Adjustments/Medicare Advantage. Evaluate medical information (Outpatient/Inpatient) documentation from a clinical standpoint for evidence of the possibility of additional medical conditions that may not have been documented in the past, and ensure accurate coding of the encounter data and recommend processes for accurate coding practices. This process involves a very strong understanding of medical coding. Ascertain that medical record documentations have accurate diagnoses and conditions to assure not to up-code, fraudulently or misrepresent the patient condition and ensure compliance to prepare for random CMS medical records audit HEDIS coding and record collection Report Coding discrep

Job Description Job Description Summary Responsible for collaborating with Manager, Lead, claims staff and Health Plans to submit, monitor and track the FFS Billing process. Additionally, the candidate will be responsible for the accuracy and integrity of the claim’s submissions, tracking and appeals related to FFS Billing. Ensures interpretation and compliance with the appropriate DOFR’s, billing guidelines and HIPAA regulations, while developing and maintaining a working knowledge of the coding and provider billing regulations relating to claims submission. Prepares claims submission, appeals and reporting for monthly Finance Reconciliation. Works directly under the Supervisor of the Finance Auditing & Recoveries unit. Duties and Responsibilities · Run reports for FFS claims monthly. · Cross train on other tasks and reporting requirements within the unit. · Make sure claims are submitted to the Health Plan electronically monthly by EDI Unit. · Work any rejections of the claims submit

Title: Claims Review Specialist (Local Only) Location: Hybrid, mostly remote 10920 Wilshire Blvd, Los Angeles, CA 90024 Duration: 24 Weeks Must be local to Los Angeles. Required Experience: At least one of these 3 certifications: CPC CPCH CCS High school diploma, GED or equivalent required, Two year degree preferred. Minimum of 3 years previous experience working for a Health Plan, IPA, or other Managed Care Organization. Minimum of 2 years previous direct experience that included verifying and maintaining provider information and provider contract configuration in a managed care transaction system. Working knowledge of one or more of the following managed care transaction systems: EPIC (Tapestry Module), EZ Cap, Facets, QNXT. Working knowledge of CPT-4, ICD-9/ICD-10, and HCPCS codes. Must have the ability to interpret a variety of instructions furnished in written, oral, diagram and schedule form including provider contracts and contract summaries. Ability to adhere to detailed data e

Job Description Job Description POSITION SUMMARY The Risk Adjustment Coder- Admin is responsible for Risk Adjustment HCC coding management and training both internally and externally to ensure that physicians, office staff and health plan representatives are working together effectively to achieve goals. Reports to Director of IPA Administration. RESPONSIBILITIES-DUTIES Review medical record information to identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC) Audit provider documentation of CPT, ICD-9 and ICD-10 codes to ensure adherence with coding and CMS Risk Adjustment guidelines Evaluate HCC auditing processes and provide analyses and recommendations to improve overall provider documentation and coding Responsible for ongoing provider education on HCC Support and participate in process and quality improvement initiatives Meet productivity and quality standards Review Comprehensive Annual We

Revenue Integrity Analyst / Claims Review Specialist Location: 10920 Wilshire Blvd, Los Angeles, CA 90024 Duration: 24 week contract SHIFT: M-F 8-5 Note: This will be 99% remote, only the orientation will be onsite and a few meetings when necessary. REQUIRED EXP: 5+ yrs exp with hospital billing systems and third-party billing requirements, Bachelor's Degree, coding certification (CPC,CPCH, AHIMA etc) Knowledge of ICD10CM CPT, Medicare, Medi-Cal and Commercial Payers processing, Denials management Preferred Take on a significant role within a world-class health organization. Elevate the operational and financial effectiveness of a complex health system. You will leverage your extensive theoretical revenue cycle knowledge as you take on a vast range of critical revenue issues. This will involve applying dashboards and processes for continuous analysis of complex revenue cycle functions while also auditing data input for all components of revenue cycle management. You will: Analyze compl

Description ATTN FERS RETIREES: Earnings received as an ATC Instructor, ATC Training Instructional Supervisor, or Contractor Site Supervisor working on this program are EXEMPT from the Supplemental Annuity earnings limits for FERS retirees between the ages of 56 and 62. We are looking for an experienced ATC supervisory candidate to fill a position as a Full-time, Contractor Site Supervisor (CSS) on the SAIC Controller Training Solutions (CTS) team providing air traffic controller training services for the Federal Aviation Administration (FAA), at the Los Angeles ARTCC (ZLA) in Palmdale, CA. This position will require the candidate to manage the overall delivery of contract training, and training support at the facility. Responsibilities include effective communications with FAA and contract personnel, execution of the CTS contract, performance and financial management of human and budgetary resources, assisting with the development of training plans, development and maintenance of trai