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Geisinger
Geisinger
Sponzor vizuma H1BDobro počutjeFarmacevtski izdelkiZdravstveno varstvo
Geisinger je zdravstvena organizacija s sedežem v Pensilvaniji, ki lokalnim skupnostim zagotavlja dostopne zdravstvene storitve in inovativno oskrbo pacientov. Organizacija je bila ustanovljena leta 1915 ter zaposluje na področjih zdravstvene nege, sorodnih zdravstvenih poklicev, administracije in drugih zdravstvenih dejavnosti, pri čemer se osredotoča na strokovni razvoj in delovno okolje, ki ceni raznolikost, enakost in vključevanje.
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Delovna mesta v podjetju

Coding and Cost Analyst I

Review Geisinger Health Plan claims, coding, and reimbursement, and recommend potential recoveries. Validate high-dollar claim payments against healthcare regulations and plan contracts.

USZdružene države AmerikePAPensilvanijaHibridnoPolni delovni časSrednja ravenSeniorZahtevani Jezik: angleščinaAnalitik

Opis

  • Review billed services, authorizations, benefit documents, itemized statements, medical records, discharge summaries, and detailed reports.
  • Recommend reimbursement or recovery based on coding, billing data, policies, industry standards, contracts, and applicable regulations.
  • Advise Health Plan departments on accurate coding, billing, and reimbursement.
  • Conduct clinical reviews for claims, claim edits, appeals, and grievances.
  • Help assess clinical risk for Underwriting, Pharmacy, and Finance.
  • Recommend recoveries in line with contracts, policies, procedures, and industry standards.
  • Review and validate pended and reconsidered claims using CPT, industry, and CMS guidelines.
  • Review high-dollar inpatient and outpatient claims and support quality concern reviews.
  • Validate claim payments against plan contracts in coordination with Pharmacy and PNM departments.
  • Create and maintain departmental tracking reports.
  • Join discussions about complex medical reviews.
  • Help onboard new team members.
  • Participate in assigned workgroups and committees.

Zahteve

  • High school diploma or GED required.
  • AAPC Certified Professional Coder (CPC) or AHIMA Certified Coding Specialist (CCS) credential required.
  • At least three years of relevant experience required.
  • Relevant experience may include related work and completed specialty training.
  • One year of specialty training counts as one year of relevant experience.
  • LPN credential preferred.
  • At least two years of clinical experience preferred.
  • Computer literacy.
  • Critical thinking skills.
  • Organizational skills.
  • A secure home office that meets HIPAA Privacy standards.
  • Ability to follow organizational policies and procedures.

Ugodnosti

  • Healthcare coverage for full-time and part-time employees starting on day one.
  • Vision coverage.
  • Dental coverage.
  • Domestic partner benefits.
  • Work-from-home arrangement.
  • Occasional onsite department meetings as needed.

Sorodna delovna mesta