Medical Auditor jobs at Conduent - 183 jobs

As a DME Auditor, you'll use your deep understanding of Durable Medical Equipment (DME), Medicare, Medicaid, and commercial reimbursement rules to review professional claims and ensure proper coding and payment. You'll analyze claims, document your findings clearly, and help our clients recover overpayments-all while making a direct impact on healthcare efficiency. Three or more years of experience in claims processing, medical billing, or auditing-with a strong focus on Durable Medical Equipment (DME). In-depth knowledge of HCPCS codes and reimbursement policies. Proven ability to read and interpret contract language and fee schedules. Intermediate Excel and Word skills, with a solid grasp of basic math. Preferred Qualifications Preferably certified with RHIA, CPC, or similar credentials (multiple credentials are a plus). Bonus if you've used: FACETS, NASCO, Encoder Pro, TrueCode, 3M, Webstrat, Pricers. Professional Qualifications Comfortable working independently in a remote environment. Strong written and verbal communication, time management, and analytical skills. Salary range $70,000.00-$80,000.00. 0-10% travel may be required. For more information on benefits and what we offer please visit us at ************************************************** Review medical records to verify services were provided as billed for Hospital Bill Audit reviews. Identify overcharges, undercharges and unbundled items. Identify unbundled items on the itemized bill specific to payer Unbundling Guidelines and provide references and rationale to support review findings. Onsite Travel - Maintain timely communication with Audit Coordinator regarding scheduling, completion and submission of audits. Abide by the EXL Travel policy while making travel arrangements for onsite audits. Scheduling Audits: Manage inventory and schedule audits timely by contacting the provider to schedule date and time to perform audits. Report any problems in the audit process to Manager for resolution. Comply with HIPAA and other regulations regarding the confidentiality of patient information. Conduct all job functions and responsibilities in accordance with all company Compliance, Information Security and Regulatory policies, procedures and programs.

Abstracts clinical information from a variety of medical records, charts and documents and assigns appropriate ICD-10 and/or CPT-4 codes to patient records according to established procedures. Works with coding databases and confirms CPT codes. Inputs and maintains data on procedures required for state or other reporting. May require an associate degree. Requires a certification from AAPC Certified Professional Coder (CPC) or AHIMA RHIT or CCS. Works with the coding manager and team on this site. Has attained full proficiency in multiple specialties of discipline. Typically requires 4+ years of related OBS/OPS coding experience, and may include additional credentials. Performs coding on multiple specialties with proficiency. Business Support

Abstracts clinical information from a variety of medical records, charts and documents and assigns appropriate ICD-10 and/or CPT-4 codes to patient records according to established procedures. Works with coding databases and confirms CPT codes. Inputs and maintains data on procedures required for state or other reporting. May require an associate degree. Requires a certification from AAPC Certified Professional Coder (CPC) or AHIMA RHIT or CCS. Works with the coding manager and team on this site. Has attained full proficiency in multiple specialties of discipline. Typically requires 4+ years of related OBS/OPS coding experience, and may include additional credentials. Performs coding on multiple specialties with proficiency. Business Support

Abstracts clinical information from a variety of medical records, charts and documents and assigns appropriate ICD-10 and/or CPT-4 codes to patient records according to established procedures. Works with coding databases and confirms DRG and CPT assignments. Inputs and maintains data on procedures required for state or other reporting. May require an associate degree. Requires an AAPC Certified Professional Coder (CPC) or AHIMA RHIT or CCS active credentials. Works with the coding manager and the coding team on this site. Works under moderate supervision. Has attained full proficiency in multiple specialties of discipline. Typically requires 4+ years of related coding experience. Performs coding on multiple specialties with proficiency. Business Support

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Description Position Purpose: Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events (inexcusable outcomes in a healthcare setting) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department. Location: This role is located at 2401 Faraway Drive, Columbia, SC 29229. There is the potential for remote work. What You'll Do: Determines methodology to identify cases for validation review. Conducts validation reviews/coordinates rates adjustments with appropriate claims area. Creates monthly/quarterly reports to present to each line of business providing information on records review, outcomes, trends, and savings that directly impact medical costs and contracting rates. Manages records retrieval, release, HIPAA compliance, and all aspects of document management. Serves as expert resource on methodology and procedures for medical records and coding issues. To Qualify for This Position, You'll Need the Following: Required Education: Associates in a job-related field. Degree Equivalency: 2 years job related work experience. Required Work Experience: 3 years medical record management to include coding and validation review experience. Skills and Abilities: Excellent verbal and written communication, organizational, customer service, and analytical or critical thinking skills. Good judgment. Ability to handle confidential or sensitive information with discretion. Extensive medical records and coding knowledge. Working knowledge of contract evaluations, claims processing and adjudication practices. Required Licenses and Certificates: Registered health information administrator (RHIA) OR Registered health information technician (RHIT) OR Certified Professional Coder (CPC) OR Certified Inpatient Coder (CIC) or Certified Professional Medical Auditor (CPMA) OR, active, unrestricted RN licensure from the United States and in the state of hire, OR, active compact multi-state unrestricted RN license as defined by Nurse Licensure Compact (NLC). Our Comprehensive Benefits Package Includes the Following: We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment. Subsidized health plans, dental and vision coverage 401k retirement savings plan with company match Life Insurance Paid Time Off (PTO) On-site cafeterias and fitness centers in major locations Education Assistance Service Recognition National discounts to movies, theaters, zoos, theme parks and more What We Can Do for You: We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company. What To Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Equal Employment Opportunity Statement BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email ************************ or call ************, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information. Some states have required notifications. Here's more information.

About BCforward BCforward began as an IT business solutions and staffing firm. Founded in 1998, BCforward has grown with our customers' needs into a full service personnel solutions organization. BCforward's headquarters are in Indianapolis, Indiana and also operates delivery centers in 17 locations in North America as well as Hyderabad, India and Puerto Rico. We are currently the largest consulting firm and largest MBE certified firm headquartered in Indiana. With 14+ years of uninterrupted growth, the addition of two brands (Stafforward and PMforward) and a team of more than 1400 resources our teams deliver services for multiple industries from both public and private sectors. BCforward's team of dedicated staffing professionals has placed thousands of talented people over the past decade, with retention rates that are consistently higher than the industry average. Job Description Basic Qualifications: - Certified Professional Coder certification required. ICD-10 certified with broad current outpatient billing/coding experience to assist in operationalizing medical policy development related matters or other projects as specified by the State. The Certified Coder must demonstrate competency in the knowledge and skills specified. - Minimum of 3 years of health care/medical industry experience - Minimum of 2 years proficiency in using PC software, including word processing, MS-Excel - Minimum of 2 years of International Classification of Disease ( ICD) experience Preferred skills: - RN/LVN - Strong knowledge of medical/dental terminology - Prior health insurance, Medicaid, and or claims processing, including ICD, NCCI and HCPCS experience - Significant experience using spreadsheet and word processing functionality - Degree in health care/medical field Professional Experience: - Excellent oral and written communications - Excellent analytical and problem solving Additional Information Must be able to pass a background and drug screen

Pearl Harbor, HI AAI is actively recruiting a Medical Coding Modernization Specialist. This position will support coding operations and compliance as part of the Medical Modernization Program. The coding professional will conduct internal audits; monitor coding practices and documentation deficiencies to identify, develop, deliver training and monitor effectiveness of efforts to ensure improvement to documentation, coding completion, timeliness and accuracy rates for the MTF. RESPONSIBILITIES Knowledge of The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-CM), procedural coding, healthcare common procedure coding system (HCPCS)/current procedural terminology (CPT) nomenclature, medical and procedural terminology, anatomy and physiology, pharmacology, and disease processes to perform the duties described. Knowledge of reimbursement systems, including Prospective Payment System (PPS) and Diagnostic Related Groupings (DRGs); Ambulatory Payment Classifications (APCs); and, ResourceBased Relative Value Scale (RBRVS). Knowledge of and the ability to interpret guidelines, rules and regulations developed by: Centers for Medicare & Medicaid Services (CMS), American Medical Association (AMA), American Heart Association (AHA) and other applicable Federal requirements so as to provide timely and accurate information relating to coding, billing and documentation. Excellent oral and written communication skills, interpersonal skills along with the confidence to present complex medical coding issues and educational instruction to a diverse audience. Must be comfortable in front of high ranking, professional staff and coding peers to training and respond to questions. Ability to write reports, business correspondence, and procedure manuals. Organizational, analytical, time management, statistical, and problem-solving skills. Advanced knowledge of computers, keyboard skills, and various software programs including Microsoft (word processing, spreadsheet and database) as well as coding software programs. Medical Coding Modernization Specialists will maintain the required continuing education hours and credentials as required by their national association certification at their own expense. Work Environment/Physical Requirements. The work is primarily sedentary. Requirements may include prolonged walking, standing, sitting, or bending. Carrying or lifting of medical records or documentation may be required daily. Use of one or more computer programs and monitors simultaneously is typical and frequent. Assists the MTF in identifying medical coding deficiencies by analyzing documentation and coding practices that may be misrepresenting or incorrectly capturing medical care activities. Analyzes historical encounter documentation and coding records from Government computer systems and medical records to identify clinical documentation improvement (CDI) and training opportunities. Compares documentation to code application to ensure accuracy. Tracks deficiencies for trending and corrective action. Collaborates with MTF leadership, MTF providers/staff, and other coding professionals related to the performance of tasks to address recurring documentation and coding deficiencies, Contacts providers to review findings to improve documentation practices as well as E&M leveling, capturing medical procedures and to improve diagnosis specificity issues IAW with coding guidelines. Develops focused training presentations from thorough analysis as outlined in the MTF modernization action plan. Seeks Government approval prior to delivering Government scheduled training to MTF providers and other staff. Creates and submits training activity reports to the MTF leadership. Presents reports to the Government weekly and identifies scheduling issues and obstacles to meeting improvement objectives. Creates monthly reports showing completed activities and improvement to metrics Education/Certification: 1. Successful completion of academic requirements, at least at an associate's degree level from a health information management program is required. 2. A Registered Health Information Technician (RHIT) or equivalent certification is required. Must have successfully completed requirements for International Classification of Diseases, Tenth Revision ICD-10-CM/PCS proficiency certification by AHIMA standards or the AAPC ICD-10-CM proficiency test prior to their start date if an equivalency determination request for AAPC certification(s) is authorized by the Government. Experience: Candidates will require a minimum of 10 years of medical coding experience in production coding environments within the past 10 years, in more than 4 medical and surgical specialties, involving assignment of ICD, E&M, CPT, and HCPCS codes. Coding, auditing and training for ancillary services such as physical, occupational therapy, speech, and nutritional medicine as well as home health, skilled nursing facilities, rehabilitation care and urgent care clinics are not qualifying. A minimum of four years of auditing, training, and/or compliance functions within the last eight years is required in at least 4 medical and surgical specialties as stated above OR candidates with three years of auditing, compliance, or training experience involving professional coding within the last five years in a DoD coding environment may be considered in lieu of 10 years for those without DoD experience. Auditing, compliance, or training experience is described as: Auditing functions include development and execution of audit plan, conducting audit according to audit plan by reviewing required documentation and determining compliance with audit standards, communicating with stakeholders during all phases of audit, and reporting on audit findings. Training functions include identifying coding training opportunities; developing coding training plans, and development/delivery of coding training to coder and physician/provider audiences. Compliance functions include identifying compliance issues and analyzing practice patterns and recommending changes to policies and procedures; recommending/updating standard policies and procedures; contribute to risk assessments and mitigation strategies; and data collection and statistical report generation. UNIQUE MILITARY HEALTH CARE DYDTEMD/PROCEDURED: Armed Forces Health Longitudinal Technology Application (AHLTA). Composite Health Care System (CHCS) and/or MHS GENESIS. Defense Enrollment Eligibility Reporting System (DEERS). Essentris™ The client-server version of the Clinical Information System (CIS). Coding Compliance Editor (CCE). Biometric Data Quality Assurance Service (BDQAS)- *********************** AFMS Internal Coding Audit Methodology - AFMOA Audit Tool/Coding Audit Review System (CARS), or current tool. MHS Coding Guidelines ********************************************************* AFMS Centralized Coding Manual. About AAI AAI is focused on delivering outstanding services to the federal government. We have extensive experience in the fields of cyber security, development, IT infrastructure, supply chain management and other professional services such as system design and continuous improvement. AAI is a VA CVE-certified Service-Disabled Veteran-Owned Small Business (SDVOSB), SBA certified Economically Disadvantaged Woman Owned Small Business (EDWOSB), and a Woman Owned Small Business (WOSB) with offices in Hampton Roads Virginia, Montgomery, AL, Washington DC and Atlanta. Fully qualified candidates are welcome to apply directly on our website at: ********************** Our benefits include: Paid Federal Holidays Robust Healthcare and Dental Insurance Options 401a plan 401k plan Paid vacation and sick leave Continuing education assistance Short Term / Long Term Disability & Life Insurance. Veterans are encouraged to apply AAI does not discriminate in employment opportunities, terms and conditions of employment, or practices on the basis of race, age, gender, religious or political beliefs, national origin or heritage, disability, sexual orientation, or any characteristic protected by law. Pending guidance from the Safer Federal Workforce, employees may in the future be required to provide evidence of COVID-19 vaccination or request and receive approval for a medical or religious exemption.

Under moderate supervision, responsible for reviewing, auditing, and data entry of medical bills for multiple states and lines of business within both Worker's Compensation and Commercial Health arenas. This would include analysis for the fee schedule or usual and customary application, as well as PPO interface, while meeting contractual client requirements. Essential Job Functions: Responsible for auditing medical bills to ensure that they are appropriate and adhere to the State Fee Schedules, customer guidelines, and PPO discounts Analysis and review of 1 or more assigned states having fee schedules Utilize Fee Schedules, Online Documents, Client instructions, and other training material to properly review medical bills Review medical bills for compensability and relatedness to injury Reprice medical bills to Workers' Compensation Fee Schedule and PPO Network Research usual and customary/fee schedule applications and system interface as appropriate Reviews specialized Medical Bills, which include hospital, surgery, and high-level physician bills for workers' compensation and non-workers' compensation claims, and may include hospital bills, auto liability, and usual and customary reimbursement Determines the appropriateness of a final reimbursement outcome by making the distinction between and knowing when to apply either Fee Schedule reduction, PPO reduction, Usual and Customary reduction, or Medicare reduction Communicates and defends to providers and clients the basis for the methodology used to accomplish the reduction of charges Analyzes and reviews high-level office visits, reports, and record reviews Interprets hospital review guidelines for both inpatient and outpatient claims Knowledge of medical terminology, workers' compensation billing guidelines, and fee schedules, including CPT/ICD/HCPS coding, and knowledge of UB04 and CMS 1500 form types preferred Responsible for producing a final review for the recommendation of payment to the client Maintain productivity, as well as speed and level of accuracy, as determined by company standards Requirements Abilities and Competencies: Current knowledge of utilization review processes and managed care Knowledge of state-based fee schedules Strong knowledge of Medical Terminology and CPT/ICD-9/ICD-10 coding Ability to identify trends through analysis of practices to improve the overall utilization of resources and cost containment Ability to communicate those trends found through analytical study using a variety of reporting mediums Ability to work collaboratively and independently while meeting productivity standards Ability to work in a high-production environment while meeting productivity and quality standards Ability to represent Utilization Management in organizational committees, as assigned Excellent relationship management skills Demonstrated ability to problem-solve in complex situations Ability to engage in abstract thought Strong organizational and task prioritization skills Strong analytical, numerical, and reasoning abilities Well-developed interpersonal skills Ability to establish credibility and be decisive - while also recognizing and supporting our organization's preferences and priorities Results-oriented with the ability to balance other business considerations Knowledgeable of multi-state workers' compensation systems Computer literacy on Microsoft Office products and database programs Ability to construct grammatically correct reports using standard medical terminology Must have a track record of producing highly accurate work, demonstrating attention to detail Education and Experience: High School Diploma or equivalent AAPC Coding Certification is required (CPC required, CIC preferred) ICD-9, ICD-10, PCS/HCPS/CPT, MS-DRG, and Geographical codes, and NCQA regulatory compliance guidelines Must have a consistent coding rate at the 95th percentile or higher RAC review and auditing Proficiency as a Specialty Medical Bill Reviewer with two or more years of previous experience in medical bill review (workers' compensation is a plus) Driving Essential: No Certifications/Licenses: AAPC Coding Certification (CPC required, CIC preferred) Position Demands: This position requires sitting, bending, stooping for up to 8 hours per day in an office setting. Ability to lift and move objects weighing up to 10 lbs. Ability to learn technical material. The person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc. Must be able to operate a computer and other office equipment such as a calculator, copy machine, printer, etc. Some travel may be required. Equal Employment Opportunity (Our EEO Statement): The Company is a veteran-owned Company and provides Equal Employment Opportunities (EEO) to all Team Members and applicants for employment without regard to race, color, religion, sex, sexual orientation, gender (including gender identity), pregnancy, childbirth, or a medical condition related to pregnancy or childbirth, national origin, age, disability, genetic information, status as a covered veteran in accordance with applicable federal, state, and local laws, or any other characteristic or class protected by law and is committed to providing equal employment opportunities. The Company complies with applicable state and local laws governing non-discrimination in employment. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, promotion, discharge, pay, fringe benefits, membership, job training, classification, and other aspects of employment. We are committed to creating an inclusive environment for all team members and applicants. We value the unique skills and experiences that veterans bring to our team and encourage veterans to apply. Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of our personnel. All team members may be required to perform duties outside of their normal responsibilities from time to time, as needed.

At HeiTech Services, our employees are our biggest assets. HeiTech Services is dedicated to attracting highly skilled and motivated professionals. We value our employees. We offer our employees challenging opportunities that facilitate professional growth and development while also providing the support you need to succeed. We are committed to your success because we understand that our employees are the driving force behind HeiTech Services' continued growth. Our mission is to help the Federal Government keep Americans safe. * Non-patient care role. This position is responsible for reviewing, prioritizing, and analyzing adverse medical events related to medical devices that are submitted on MedWatch reporting forms via hard copy or electronically to our customer, the Food and Drug Administration (FDA). Additionally, this position is responsible for processing and coding a variety of reports from device manufacturers (MFR), importers, user facilities, health care professionals, and customers. While Analyst Coders may be assigned to perform the primary functions shown above, they will also be cross-trained to perform secondary duties according to business needs. Security Clearance: Must possess or be able to obtain a Public Trust Clearance. Location: This position requires onsite attendance in the office (Landover, MD) during the training period. After successful completion of training, the role may be eligible for remote or hybrid work arrangements. Essential Functions: Analyze all MedWatch reporting forms to determine if they meet the designated Code Blue criteria as identified by FDA. Assign the appropriate product, manufacturer, patient, and device problem codes that correlate with the patient consequences that occurred due to the use of the device. Enter the product code, MFR shortname, patient and device codes into the FDA proprietary database application. Take phone reports from the general public and translate the data to the MedWatch 3500 form. Identify reports not regulated by the Center for Devices and Radiological Health (CDRH) and inform the Supervisor for forwarding to the appropriate FDA Center. Participate in team meetings to discuss coding and other processing issues. Interact with Administrative, Data Entry, Quality Control, and Editor staff to process the reports according to quality guidelines of the contract. Query databases for information needed in the processing of the reports. Ensure the accuracy of data entered into critical fields, per coding principles and procedures and the Standard Operating Procedures (SOPs). Perform data entry functions as needed; and provide quality assurance of the entered data providing critical feedback to data entry staff using a database designed to capture, track, and report errors. Perform coding in accordance with FDA instructions for coding and ICH Coding Principles for documents. Perform quality control and quality assurance procedures to ensure the appropriate selection of codes. Interface with internal users as well as external stakeholders. Apply and use MS Office Suite tools Microsoft Word and Microsoft Excel. Review and retrieve system data, match output with specifications in accordance with Standard Operating Procedures and resolve discrepancies. Requirements Must possess a Bachelor's degree in related health science fields such as nursing, pharmacy, veterinary, and/or certified licensed technicians as appropriate for each center. Good telephone etiquette. Clinical experience in the different medical specialties. Team player, good organizational skills, flexible, open to feedback, and sensitive to time related deadlines. Attention to detail and ability to note and implement the changing regulations and procedures. Basic computer and typing skills. HeiTech Services is an Equal Opportunity Employer. We consider all qualified applicants without regard to race, color, religion, sex (including pregnancy, sexual orientation, gender identity), national origin, age, disability, veteran status, or any other protected status. If you need a reasonable accommodation during the application process, please contact **********************.

At Medusind we take immense pride in offering superior, cost-effective solutions covering the whole spectrum of tasks and processes to the healthcare industry. A significant factor is that our workforce comes with a rich domain expertise and robust compliance norms. Our four-prong approach of an excellent management team coupled with detailed eye for processes, experienced manpower, and cutting edge technology helps us deliver superior, cost effective services to our clients across the globe. Job Description SUMMARY: This position is a member of a team that is responsible for coding review, coding education, and charge entry. The goal of the team is to ensure correct coding, timely charge entry, billing compliance, and to provide on-going coding education to providers and staff. RESPONSIBILITIES: Stays up-to-date on coding rules and CPT/ICD/HCPCS codes. Stays up-to-date on 3rd party payer rules and integrates those rules into daily work. Review for accuracy all charge slips submitted by the Medusind clients and hospital departments. Make corrections based on the medical documentation. Assist the department manager with collecting data for trends to help develop training plans for clients and providers. Assist billing office in addressing billing concerns from the Collections team as necessary. Perform random audits on charts. Data entry of the charges in a timely and accurate fashion. Perform other duties as assigned. Participate in continuing education sessions. Foster and maintain excellent relationships with Medusind clients. Qualifications KNOWLEDGE, SKILLS, AND ABILITIES: Minimum of five years experience working with CPT, ICD-10 and HCPCS codes. A strong understanding of coding requirements. Must either possess a CPC certification or a CCS certification. 1 year Radiology, Neurology and Medicare Part B coding experience. Knowledge of computer applications and Microsoft Office processing. Additional Information All your information will be kept confidential according to EEO guidelines.

At Medusind we take immense pride in offering superior, cost-effective solutions covering the whole spectrum of tasks and processes to the healthcare industry. A significant factor is that our workforce comes with a rich domain expertise and robust compliance norms. Our four-prong approach of an excellent management team coupled with detailed eye for processes, experienced manpower, and cutting edge technology helps us deliver superior, cost effective services to our clients across the globe. Job Description SUMMARY: This position is a member of a team that is responsible for coding review, coding education, and charge entry. The goal of the team is to ensure correct coding, timely charge entry, billing compliance, and to provide on-going coding education to providers and staff. RESPONSIBILITIES: Stays up-to-date on coding rules and CPT/ICD/HCPCS codes. Stays up-to-date on 3rd party payer rules and integrates those rules into daily work. Review for accuracy all charge slips submitted by the Medusind clients and hospital departments. Make corrections based on the medical documentation. Assist the department manager with collecting data for trends to help develop training plans for clients and providers. Assist billing office in addressing billing concerns from the Collections team as necessary. Perform random audits on charts. Data entry of the charges in a timely and accurate fashion. Perform other duties as assigned. Participate in continuing education sessions. Foster and maintain excellent relationships with Medusind clients. Qualifications KNOWLEDGE, SKILLS, AND ABILITIES: Minimum of five years experience working with CPT, ICD-10 and HCPCS codes. A strong understanding of coding requirements. Must either possess a CPC certification or a CCS certification. 1 year Radiology, Neurology and Medicare Part B coding experience. Knowledge of computer applications and Microsoft Office processing. Additional Information All your information will be kept confidential according to EEO guidelines.

Thank you for your interest in i.c.stars! YOUR FUTURE IN TECH, STARTS TODAY! We are now accepting applications for the upcoming cycle. APPLY TODAY! Who are we?: i.c.stars |* is an immersive, technology-based leadership training program for promising young adults. The basics: Participants in the program start as *Interns. As an i.c.stars |* Intern, you participate in a 16-week paid training program, which includes: project-based learning to build leadership skills and emotional intelligence core technical skills training in coding: JavaScript, HTML, CSS, C#, and SQL Networking opportunities with Executives and Professionals in the IT field Career preparation and placement assistance Upon completing the 16-weeks, *Interns graduate to become *Residents. Residency includes: 20 months of professional and social service support Access to laptops and software Business and Leadership Development events College Enrollment Assistance Our minimum requirements: Minimum age 18 or older Demonstrate financial need GED recipient or High School graduate (Bachelor degree candidates are not eligible, some college accepted) Have never attended a coding bootcamp in the past Available to attend training from 8AM-8PM, Monday-Friday for 16 weeks 6 months previous full-time work experience preferred Agree to a strict 'On Time, No Absence' policy

Thank you for your interest in i.c.stars! YOUR FUTURE IN TECH, STARTS TODAY! We are now accepting applications for the upcoming cycle. APPLY TODAY! Who are we?: i.c.stars |* is an immersive, technology-based leadership training program for promising young adults. The basics: Participants in the program start as *Interns. As an i.c.stars |* Intern, you participate in a 14-week paid training program, which includes: project-based learning to build leadership skills and emotional intelligence core technical skills training in coding: JavaScript, HTML, CSS, C#, and SQL Networking opportunities with Executives and Professionals in the IT field Career preparation and placement assistance Upon completing the 14-weeks, *Interns graduate to become *Residents. Residency includes: 20 months of professional and social service support Access to laptops and software Business and Leadership Development events College Enrollment Assistance Our minimum requirements: Minimum age 18 or older Demonstrate financial need GED recipient or High School graduate (Bachelor degree candidates are not eligible, some college accepted) Have never attended a coding bootcamp in the past Available to attend training from 8:30 AM-7:00 PM, Monday-Friday for 14 weeks 6 months previous full-time work experience preferred Agree to a strict 'On Time, No Absence' policy

Job DescriptionDescription: At HeiTech Services, our employees are our biggest assets. HeiTech Services is dedicated to attracting highly skilled and motivated professionals. We value our employees. We offer our employees challenging opportunities that facilitate professional growth and development while also providing the support you need to succeed. We are committed to your success because we understand that our employees are the driving force behind HeiTech Services' continued growth. Our mission is to help the Federal Government keep Americans safe. * Non-patient care role. This position is responsible for reviewing, prioritizing, and analyzing adverse medical events related to medical devices that are submitted on MedWatch reporting forms via hard copy or electronically to our customer, the Food and Drug Administration (FDA). Additionally, this position is responsible for processing and coding a variety of reports from device manufacturers (MFR), importers, user facilities, health care professionals, and customers. While Analyst Coders may be assigned to perform the primary functions shown above, they will also be cross-trained to perform secondary duties according to business needs. Security Clearance: Must possess or be able to obtain a Public Trust Clearance. Location: This position requires onsite attendance in the office (Landover, MD) during the training period. After successful completion of training, the role may be eligible for remote or hybrid work arrangements. Essential Functions: Analyze all MedWatch reporting forms to determine if they meet the designated Code Blue criteria as identified by FDA. Assign the appropriate product, manufacturer, patient, and device problem codes that correlate with the patient consequences that occurred due to the use of the device. Enter the product code, MFR shortname, patient and device codes into the FDA proprietary database application. Take phone reports from the general public and translate the data to the MedWatch 3500 form. Identify reports not regulated by the Center for Devices and Radiological Health (CDRH) and inform the Supervisor for forwarding to the appropriate FDA Center. Participate in team meetings to discuss coding and other processing issues. Interact with Administrative, Data Entry, Quality Control, and Editor staff to process the reports according to quality guidelines of the contract. Query databases for information needed in the processing of the reports. Ensure the accuracy of data entered into critical fields, per coding principles and procedures and the Standard Operating Procedures (SOPs). Perform data entry functions as needed; and provide quality assurance of the entered data providing critical feedback to data entry staff using a database designed to capture, track, and report errors. Perform coding in accordance with FDA instructions for coding and ICH Coding Principles for documents. Perform quality control and quality assurance procedures to ensure the appropriate selection of codes. Interface with internal users as well as external stakeholders. Apply and use MS Office Suite tools Microsoft Word and Microsoft Excel. Review and retrieve system data, match output with specifications in accordance with Standard Operating Procedures and resolve discrepancies. Requirements: Must possess a Bachelor's degree in related health science fields such as nursing, pharmacy, veterinary, and/or certified licensed technicians as appropriate for each center. Good telephone etiquette. Clinical experience in the different medical specialties. Team player, good organizational skills, flexible, open to feedback, and sensitive to time related deadlines. Attention to detail and ability to note and implement the changing regulations and procedures. Basic computer and typing skills. HeiTech Services is an Equal Opportunity Employer. We consider all qualified applicants without regard to race, color, religion, sex (including pregnancy, sexual orientation, gender identity), national origin, age, disability, veteran status, or any other protected status. If you need a reasonable accommodation during the application process, please contact **********************.

Responsible for configuration and simulation on Checklist Manager application (prototypes and reports). Must have knowledge of databases and the SQL language (for reports that's critical) and experience in the pharmaceutical industry. Requirements: Have a portfolio of projects in programming (it can be a University project). Have experience in software projects. Tasks:: Assist the document owner to deliver effective and efficient solutions to ensure that the project configuration deliverables. Develop and maintain configuration policies and procedures. Work with management to prioritize business needs. Identify new process improvement and necessities for Client's Site to share information with Global Team. Write assessments and evaluations for investigations. Provide support in developing, implementing, and testing patch releases and system upgrades. Provide training and system configuration for existing and new business applications. Support the documentation efforts for testing plans and new version updates. Conduct software demonstrations of features and capabilities. Provide end -user help as required. Requirements BS Computer Science, Computer Engineering, Information Systems Have knowledge in some programming language: Python, C++, C#, Java, JavaScript, SQL (for create configuration) Fully bilingual (Spanish/English)(Written/Spoken)

Thank you for your interest in i.c.stars! YOUR FUTURE IN TECH, STARTS TODAY! We are now accepting applications for the upcoming cycle. APPLY TODAY! Who are we?: i.c.stars |* is an immersive, technology-based leadership training program for promising young adults. The basics: Participants in the program start as *Interns. As an i.c.stars |* Intern, you participate in a 16-week paid training program, which includes: project-based learning to build leadership skills and emotional intelligence core technical skills training in coding: JavaScript, HTML, CSS, C#, and SQL Networking opportunities with Executives and Professionals in the IT field Career preparation and placement assistance Upon completing the 16-weeks, *Interns graduate to become *Residents. Residency includes: 20 months of professional and social service support Access to laptops and software Business and Leadership Development events College Enrollment Assistance Our minimum requirements: Minimum age 18 or older Demonstrate financial need GED recipient or High School graduate (Bachelor degree candidates are not eligible, some college accepted) Have never attended a coding bootcamp in the past Available to attend training from 8AM-8PM, Monday-Friday for 16 weeks 6 months previous full-time work experience preferred Agree to a strict 'On Time, No Absence' policy

BCforward began as an IT business solutions and staffing firm. Founded in 1998, BCforward has grown with our customers' needs into a full service personnel solutions organization. BCforward's headquarters are in Indianapolis, Indiana and also operates delivery centers in 20 locations in North America as well as India and Puerto Rico. We are currently the largest consulting firm and largest MBE certified firm headquartered in Indiana. Job Description Position: Medical Coder Location: PHILADELPHIA PA 19103 Duration: 3+months Rate: $14.80/Hr on W2 Contractor will sign on daily chart review application to review medical records for risk adjustment coding. The coder will identify risk adjustment codes based upon coding guidelines. The coder will be knowledgeable and familiar with computers and technology. The coder will be a certified professional coder with at least 2 years of experience. The coder will meet 3x a week with a coding manager to review metrics and progress to-date. Additional Information Namratha Gandavarapu Sr. Recruiter Direct: ************

BCforward began as an IT business solutions and staffing firm. Founded in 1998, BCforward has grown with our customers' needs into a full service personnel solutions organization. BCforward's headquarters are in Indianapolis, Indiana and also operates delivery centers in 20 locations in North America as well as India and Puerto Rico. We are currently the largest consulting firm and largest MBE certified firm headquartered in Indiana. Job Description Position: Medical Coder Location: PHILADELPHIA PA 19103 Duration: 3+months Rate: $14.80/Hr on W2 Contractor will sign on daily chart review application to review medical records for risk adjustment coding. The coder will identify risk adjustment codes based upon coding guidelines. The coder will be knowledgeable and familiar with computers and technology. The coder will be a certified professional coder with at least 2 years of experience. The coder will meet 3x a week with a coding manager to review metrics and progress to-date. Additional Information Namratha Gandavarapu Sr. Recruiter Direct: ************

Healthcare Risk Advisors is seeking a medical malpractice Claims Specialist to join our claims team. This is a hybrid opportunity based out of New York City. This position is responsible for performing investigations, evaluations, negotiations, and settlements to equitably resolve claims. Position conducts business with policyholders and others in a manner that achieves economy and upholds the company's reputation for quality service. This position has contacts with employees, vendors, lawyers, and policyholders. This position works under immediate supervision. Qualifications: * Bachelor's degree required. * Minimum of 2-5 years as a claims adjuster, paralegal, attorney, or related experience. * Adjusters license required, or JD in lieu of requirement. * Excellent interpersonal and organizational skills. * Strong knowledge of medical malpractice law. * Strong listening skills. * Strong negotiating skills. * Strong Microsoft Office Suite skills. Responsibilities: Service / Support Delivery * Provides clear communication to client and follows up as necessary based on expectations agreed to with the client. * Maintains awareness of client's needs and context of their communication in order to provide proper support. * Elevates concerns expressed by the insured client to management as necessary. * Provides excellent service to team members who submit requests to the team. * Provides high-quality, comprehensive work product that facilitates efficient/effective downstream workflow. * Identify and elevate ERM exposure. Claim Guidelines * Adhere to best practices. * Understands the venues, applicable law and reserving philosophy of HRA to properly evaluate the exposures contained within the assigned caseload. * Ensures effective documentation of established reserves. Claims Investigation / Analysis * Provides timely analysis of cases to establish appropriate reserves. * Escalate cases that are unique or unusual to leadership for evaluation, escalation, and communication as necessary. * Determines the proper course of resolution based on the directed investigation by assigned staff and makes recommendations to leadership accordingly. * Gives appropriate insight and advice to clients, staff and defense counsel on the best possible outcome for both the insured client and the company. * Completes coverage analysis and requests coverage review as appropriate. * Makes appropriate and decisive decisions to establish a plan of action on all cases assigned to the team. * Directs all reporting to High Exposure Committee and Reinsurers as necessary. Litigation Management & Claims Resolution * Makes recommendation for assignment of litigated matters to appropriate defense panel members based on ability and experience. * Partners with defense counsel for optimum outcome on all assigned cases. * Monitors and approves fees and expenses within authority to comply with company guidelines and state statutory guidelines. * Attends and monitors (directly or indirectly) settlement conferences, mediations and trials, reports out timely and insightfully, and escalates as needed. * Evaluates attorney work product/performance and advises supervisor of any need for corrective action or improvement. * Recommends the proper course of resolution timely to leadership and/or client based on the investigation and discovery. Technical Knowledge and Professional Development * Maintain technical knowledge and skills to efficiently and effectively support and advance the department strategic plan and goals. * Completes any training required to maintain or advance the skills set necessary to reach department and company goals. Other Duties as Assigned * Makes oneself available for any and all duties. * Accepts delegated tasks readily and completes assigned duties as directed. Salary Range: $115,123 - $151,099 Compensation varies based on skills, knowledge, and education. We consider factors such as specialized skills, depth of knowledge in the field, and educational background to ensure fair and competitive pay. Benefits: Healthcare Risk Advisors offers competitive compensation, an incentive bonus plan, outstanding career opportunities, an exceptional work environment, and an impressive benefits package, which starts with medical, family and bereavement leave; same-sex domestic partner benefits; short- and long-term disability programs; and an employee assistance program. There's more: * Health, dental, and vision insurance * Health and dependent care tax-free spending accounts with a company match * 401(k) and Roth IRA with company match, as well as catch-up plans for both * Paid vacation, sick days, and personal days each calendar year (with vacation increases based on length of service) * 11 paid holidays each calendar year * Life and travel insurance * Tax-free commuter benefits * In-person and online learning opportunities * Cross-function career opportunities * Business casual work environment * Time off to volunteer * Matching donations to qualifying nonprofit organizations * Company-sponsored participation at non-profit events