The incumbent performs audits on procedural billing, facility E&M, and ICD-10 coding to ensure accuracy and compliance with reimbursement rules. They also assist in training departmental personnel on documentation processes and coding guidelines.
The Integrated Care Coordinator manages the end-to-end care journey for complex neurosurgery patients, including scheduling, diagnostic testing, and surgical coordination. They serve as the primary liaison between patients and the clinical team to ensure seamless communication and optimal treatment outcomes.
Reconcile outpatient clinic and provider visits, review medical records, and abstract and code services for professional or facility billing. Resolve complex claims, communicate billing and documentation issues to relevant staff, apply regulatory and reimbursement guidelines, and support quality standards and coder training.
The Patient Services Specialist acts as a liaison between patients and clinical staff, managing complex scheduling, appointment coordination, and pre-procedure instructions. They are also responsible for handling insurance authorizations, processing payments, and maintaining accurate patient records.
This position is responsible for abstracting, coding, and interpreting outpatient clinic and provider services for billing purposes. The role also involves resolving documentation inconsistencies, serving as a resource for staff, and educating personnel on regulatory coding guidelines.
The specialist performs thorough medical record reviews to identify and assign accurate ICD-CM and ICD-10 PCS codes for inpatient facility coding. They also provide clinical documentation improvement support and ensure compliance with official coding guidelines and hospital policies.
The Prior Authorization Rep II is responsible for verifying insurance eligibility, calculating patient estimates, and securing prior authorizations for complex medical services. They act as a liaison between payers, medical staff, and providers to resolve authorization issues and ensure financial security for the organization.
The Nurse Specialist improves the quality and completeness of clinical documentation by educating physicians and staff on documentation standards. They facilitate modifications to medical records to ensure accurate reflection of patient status, clinical treatment, and appropriate reimbursement.
