XGEN (ChikaLive)
Essential Job Responsibilities & Key Performance Outcomes Provide additions, deletions or updates to diagnosis codes, procedure codes, age minimums & maximums, quantity limitations, place of service limitations and other clinical content criteria Provide written and oral presentations to Medical Director (physicians) and other clinical colleagues to obtain consensus on proposed denial criteria Provide clinical content support to our customers as needed Perform data entry of clinical content updates into database, as needed Solve problems related to the interpretation of inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion or exclusion within Lyric business rules Responsible for making recommendations within the software for the denial of diagnosis, age, or other criteria on medical claims based on coding guidelines Required Skills & Experience BS Nursing or equivalent required 4 years’ experience in medical billing, coding, claims processing, bill and/or chart review/auditing, is required. Previous experience working with US health insurance payers in a claims, appeals or coding capacity is also required Experience in denial management or claim review management is a plus Excellent communication skills (verbal and written) enabling effective communication both internally with all areas of the business and externally Demonstrated proficiency with various software applications, including but not limited to: MS Word; MS Excel; MS Access; Visio; JIRA; SharePoint with MS project a plus AHIMA Certified Coding Specialist – Physician (CCS-P) or AAPC Certified Professional Coder (CPC) is required Benefits Health insurance Life insurance Opportunities for promotion Pay raise Work from home Application Question(s): Are you a Nursing Graduate? Education: Bachelor's (Preferred) Work Location: Remote
XGEN (ChikaLive)
