the smart solution for Chesterfield jobs

Medical Coding Reviewer I

Company: Centene Corporation
Location: Chesterfield
Posted on: December 5, 2018

Job Description:

Pipeline - General Position Purpose: Perform clinical/coding medical claim review to ensure compliance with coding practices through a comprehensive review and analysis of medical claims, medical records, claims history, state regulations, contractual obligations, corporate policies and procedures and guidelines established by the American Medical Association and the Centers for Medicare and Medicaid Services. -- Analyze provider billing practices by utilizing code auditing software, provider documentation, administrative policies, regulatory codes, legislative directives, precedent, AMA and CMS code edit criterion. -- Review medical records to ensure billing is consistent with medical record for appeals, adjustments and miscellaneous/unlisted code review. -- Review cases with Medical Director to validate decisions and identify opportunities to create medical policy in the absence of guidelines -- Assist with research of health plan coding questions. -- Identify potential billing errors, abuse, and fraud. -- Identify opportunities to flag potential cases which may warrant a prepayment review (versus an automatic system denial or payment). -- Maintain appropriate records, files, documentation, etc Education/Experience: Associates degree in related field or equivalent experience. Coding certification and 2 years of experience in medical billing & coding OR RN/LPN and 2 years of related clinical experience. Experience in provider communication and education preferred. License/Certification: LPN, RN, CPC, CPC-H, CPC-P, CPC-A, CCS, CCS-P, RHIT, RHIA, or CPMA Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Keywords: Centene Corporation, Chesterfield , Medical Coding Reviewer I, Healthcare , Chesterfield, Missouri

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category

Other Healthcare Jobs

Psychiatry in MO - A Psychiatrist is Needed for Temporary Coverage in Missouri
Description: Psychiatric-Mental Health opening in Saint Louis, Missouri. This and other physician jobs brought to you by We are assisting a Missouri-based inpatient facility that is currently
Company: CompHealth
Location: Saint Louis
Posted on: 12/14/2018

Med Tech/Med Lab Tech - ASCP Certification REQUIRED
Description: Med Tech/ Medical Lab Technician Travel MLTtrustaff currently has a travel position available for a Medical Lab Technician. This assignment is for an immediate start with a reputable facility seeking (more...)
Company: Trustaff
Location: Saint Louis
Posted on: 12/14/2018

RN - Home Care in Saint Louis
Description: Premier Medical Staffing Services has a great contract assignment for RN Home Care in Saint Louis MO. The ideal candidate will possess a current MO license. This is a 7:00A-3:30P 8hrs position. Includes (more...)
Company: Premier Medical Staffing Services
Location: Saint Louis
Posted on: 12/14/2018

Part Time Massage Therapist
Description: Overview Are you ready to focus on doing what you love in a place that helps you feel and deliver your best Massage Envy is the leader in accessible massage and skin care. As a massage therapist at our (more...)
Company: Massage Envy
Location: Saint Louis
Posted on: 12/14/2018

Physical Therapist (PT) Home Health - Missouri
Description: Physical Therapist PT Benefits br br br br br ul br br li 10,000 in Sign on Bonus. br li Outpatient or Home Health Positions Available br li Earn up to 98,000 per year. (more...)
Company: Delta Healthcare Providers-Perm
Location: Saint Louis
Posted on: 12/14/2018

Medical Billing Clerk - Medical Claims Processor
Description: Adecco is assisting a local client in their search for qualified Medical Billing Clerk - Medical Claims Processor and Medical Billing Clerk - Medical Claims Processor in Olivette, MO. This is a temporary (more...)
Location: Saint Louis
Posted on: 12/14/2018

Personal Banker 1 (On-Site Location) - Barnes Jewish Hospital, MO
Description: At U.S. Bank, we're passionate about helping customers and the communities where we live and work. The fifth-largest bank in the United States, we're one of the country's most respected, innovative and (more...)
Company: US Bank
Location: Saint Louis
Posted on: 12/14/2018

Travel Registered Nurse RN Telemetry
Description: Date Posted:2018-12-10 br br Occupation Category: 29-1141.00 Registered Nurses br br JOB DESCRIPTION br Travel Registered Nurse RN Telemetry br br br Location:SAINT LOUIS, Missouri br (more...)
Company: OneStaff Medical
Location: Saint Louis
Posted on: 12/14/2018

MedSurg RN Assignment: Saint Louis, Missouri
Description: Travel Nurse across America is seeking a qualified
Company: Travel Nurse Across America
Location: Saint Louis
Posted on: 12/14/2018

Operating Room RN
Description: Be Adventurous, Make
Company: Tact Medical Staffing
Location: Saint Louis
Posted on: 12/14/2018

Log In or Create An Account

Get the latest Missouri jobs by following @recnetMO on Twitter!

Chesterfield RSS job feeds