Caduceus
Claims Review Specialist
Review and clear claim edits in the system (types of edits, registration, insurance, charge and related edits) in a high-volume practice. Essential Functions: Registration: Using documentation supplied by client in either paper or electronic form enters all demographic information into Athena system as required. Charge Entry: Using documentation supplied by client in either paper or electronic form enters all charge information into Athena system as required. Medical Coding: Coding processes are conducted only by Caduceus certified Coders or Client. All codes supplied by client must be entered "as is" unless specific written instructions are provided by the Revenue Cycle Manager from the practice or by Caduceus Coding Director. TES Edits (IDX) and Claim Errors (Athena): Review and resolve edits as required for timely submission of claims. This does not include coding edits that will need to be resolved by Caduceus Certified Coders or practice. Patient Keeper Hold: Reviews and resolves Patient Keeper holds as required by escalation. Other assigned tasks/duties Preferred Skills & Experience: Experience level: 1-3 years. Multi-Specialty Billing Experience. Experience with various billing software. Experience working in a medical billing environment where compliance with protected health information and HIPAA compliance is strongly enforced. ICD-9/10, CPT and Medical Terminology Trained High degree of accuracy on data entry and good keying speed up to 150 encounters/day is typical. Ability to read, understand and interpret charge tickets, superbills and hospital demographic documents. Excellent systems skills. Microsoft Excel proficiency Work Environment: A standard business environment exists with moderate noise levels. Ability to lift and move approximately thirty (30) pounds on a non-routine basis. Ability to sit for extended periods of time. Long periods of computer usage Handling seizing, holding, grasping and fingering of objects, tools and controls. Vision close vision Hearing- ability to receive detailed information through oral and telephonic communication.
Review and clear claim edits in the system (types of edits, registration, insurance, charge and related edits) in a high-volume practice. Essential Functions: Registration: Using documentation supplied by client in either paper or electronic form enters all demographic information into Athena system as required. Charge Entry: Using documentation supplied by client in either paper or electronic form enters all charge information into Athena system as required. Medical Coding: Coding processes are conducted only by Caduceus certified Coders or Client. All codes supplied by client must be entered "as is" unless specific written instructions are provided by the Revenue Cycle Manager from the practice or by Caduceus Coding Director. TES Edits (IDX) and Claim Errors (Athena): Review and resolve edits as required for timely submission of claims. This does not include coding edits that will need to be resolved by Caduceus Certified Coders or practice. Patient Keeper Hold: Reviews and resolves Patient Keeper holds as required by escalation. Other assigned tasks/duties Preferred Skills & Experience: Experience level: 1-3 years. Multi-Specialty Billing Experience. Experience with various billing software. Experience working in a medical billing environment where compliance with protected health information and HIPAA compliance is strongly enforced. ICD-9/10, CPT and Medical Terminology Trained High degree of accuracy on data entry and good keying speed up to 150 encounters/day is typical. Ability to read, understand and interpret charge tickets, superbills and hospital demographic documents. Excellent systems skills. Microsoft Excel proficiency Work Environment: A standard business environment exists with moderate noise levels. Ability to lift and move approximately thirty (30) pounds on a non-routine basis. Ability to sit for extended periods of time. Long periods of computer usage Handling seizing, holding, grasping and fingering of objects, tools and controls. Vision close vision Hearing- ability to receive detailed information through oral and telephonic communication.