Review and process medical claims by verifying member eligibility and applying coding standards to ensure accuracy. Coordinate with providers and internal departments to resolve discrepancies and maintain compliance with healthcare regulations.
MedPOINT Management
16 Remote Job Openings at MedPOINT Management
The Hospital Claims Auditor ensures the quality and compliance of claims processes according to regulations and contractual obligations. They audit adjudicated claims for accuracy, provide feedback to examiners, and suggest process improvements to management.
The role involves conducting patient assessments and collaborating with healthcare providers to develop and implement care plans. The manager is also responsible for monitoring patient progress, ensuring regulatory compliance, and facilitating communication between families and medical teams.
Review and analyze hospital claims for accuracy and compliance while resolving discrepancies with healthcare providers. Maintain detailed records and assist in developing claims processing guidelines to maximize reimbursement.
The Applications Specialist provides technical support, training, and troubleshooting for healthcare applications to ensure maximum uptime. They collaborate with cross-functional teams to optimize performance and assist in the implementation of new software solutions.
Provide first-level technical support for web portal users and monitor system performance to ensure optimal functionality. Collaborate with cross-functional teams to enhance portal features and document support processes in a knowledge base.
The role involves conducting comprehensive reviews of inpatient cases to determine medical necessity and collaborating with healthcare teams to implement treatment plans. The coordinator is also responsible for monitoring patient progress and maintaining accurate documentation in compliance with regulatory standards.
The role involves accurately entering and maintaining patient data within electronic health record systems while ensuring HIPAA compliance. Additionally, the clerk supports clinical staff by preparing data summaries and responding to administrative inquiries.
The role involves managing and responding to web inquiries professionally while coordinating with internal departments to resolve client issues. Additionally, the coordinator will analyze inquiry trends and collaborate with marketing to improve the online client experience.
Internal Audit Credentialing Specialist
MedPOINT Management
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Full Time
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2 hours ago
MedPOINT Management
Conduct internal audits of credentialing files to ensure regulatory compliance and verify healthcare provider credentials. Maintain accurate databases and collaborate with teams to improve operational efficiency and reporting.
The role involves conducting utilization reviews for outpatient services and collaborating with healthcare providers to assess patient treatment plans. Additionally, the clinician manages insurance authorizations, appeals, and participates in quality improvement initiatives.
Coordinate inpatient admissions and discharges during evening and weekend shifts. Serve as the primary point of contact for hospital staff and patients while managing records and emergency situations.
The Client Account Manager acts as a strategic liaison between clients, healthcare providers, and internal teams to ensure seamless service delivery. They are responsible for resolving operational challenges, managing escalated issues, and monitoring account performance metrics.
Medical Claims Clinical Review Nurse
MedPOINT Management
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Full Time
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2 hours ago
MedPOINT Management
Conduct thorough clinical reviews of medical claims to ensure policy compliance and assess the medical necessity of services. Collaborate with healthcare providers to resolve discrepancies and document findings within the claims management system.
The role involves engaging with members through various channels to promote services, gather feedback, and assist with healthcare plan inquiries. The representative will also track engagement metrics and participate in community events to foster relationships.
The role involves reviewing and processing insurance claims accurately while ensuring compliance with company and regulatory policies. It also requires communicating with clients and insurance companies to resolve discrepancies and analyzing data for process improvements.
