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Exceptional jobs in Dallas, TX

- 5 jobs
  • Medical Coding Auditor

    Exceptional Healthcare Inc. 4.0company rating

    Exceptional Healthcare Inc. job in Dallas, TX

    Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Job Responsibilities/Duties: · Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or MS-DRG assignment. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records to determine accurate required abstracting elements (facility/client/payer-specific elements) including appropriate discharge disposition · IP, OP Coding: Reviews medical records for the determination of accurate assignment of all documented ICD-10-CM codes for diagnoses and procedures. Abstracts accurate required data elements (facility/client specific elements) including appropriate discharge disposition. · Coding: Uses discretion and specialized coding training and experience to accurately assign ICD-10, CPT-4 codes to patient medical records. · Abstracting: Reviews medical records to determine accurate required abstracting elements (client specific elements) including appropriate discharge disposition. · Coding Quality: Demonstrates ability to achieve accuracy and consistency in the selection of principal and secondary diagnoses (including MCC & CC) and procedures. Demonstrates ability to achieve accuracy and consistency in abstracting elements defined by SOW. · Professional Development: Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM and CPT coding. Attends mandatory coding seminars on an annual basis (IPPS and OPPS, ICD-10-CM, and CPT updates) for inpatient and outpatient coding. Quarterly review of AHA Coding Clinic. Attends Quarterly Coding Updates and all coding conference calls · Create audit schedules and manage workflows to adhere to the audit schedule. · Develop methods to effectively communicate information through presentations, graphs, reports, educational materials, etc. · Develop, establish, and review policies and objectives consistent with those of the organization to ensure efficient departmental operations. · Performs charge audits by comparing itemized bills to medical record documentation to ensure appropriate charging. · Review, assess, study, and analyze the overall coding, billing, documentation, and reimbursement system for potential compliance problems. · Performs all other duties as assigned. Qualifications & Experience: · Ability to consistently code at 95% accuracy and quality while maintaining client-specified production standards · Must successfully pass a coding test · Knowledge of medical terminology, ICD-9-CM and CPT-4 codes · Must be detail-oriented and can work independently · Computer knowledge of MS Office · Must display excellent interpersonal skills · The coder should demonstrate initiative and discipline in time management and assignment completion · The coder must be able to work in a virtual setting under minimal supervision · Intermediate knowledge of disease pathophysiology and drug utilization · Intermediate knowledge of MS-DRG classification and reimbursement structures · Intermediate knowledge of APC, OCE, NCCI classification and reimbursement structures EDUCATION / EXPERIENCE · Associate degree in a relevant field preferred or a combination of the equivalent of education and experience · Three years of coding experience including hospital and consulting background CERTIFICATES, LICENSES, REGISTRATIONS · AHIMA Credentials, and or AAPC · Certified Professional Medical Auditor by AAPC PHYSICAL DEMANDS · Requires visual acuity to inspect and analyze work close to the eyes and ability to hear sound with or without correction; Ability to climb, stoop, kneel, reach, stand, walk pull, push lift, and able to exert up to 40 pounds of force occasionally and/or up to 10 pounds of force constantly to move objects. · Moderate physical activity performing somewhat strenuous daily activities of a primarily administrative nature. · The physical demands for this position include adequate vision, hearing, and repetitive motion. · Ascending or descending stairs, ramps, and the like, using feet and legs and/or hands and arms. · Substantial movements (motion) of the wrist, hands, and/or fingers in a repetitive manner - Bending legs downward and forward by bending leg and spine - Standing, particularly for sustained periods of time. Using upper extremities to exert force to draw, drag, haul or tug objects in a sustained motion. · Raising objects from a lower to a higher position or moving object horizontally from position to position WORK CONDITIONS • While performing the duties of this job, the employee is frequently required to stand, walk, sit, reach with hands and arms, and talk or hear. • The employee is occasionally required to stoop, kneel, crouch, or crawl and taste or smell. • The employee is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures, transcribing, and viewing a computer terminal. Powered by JazzHR gVCkZcc1h2
    $42k-57k yearly est. 28d ago
  • Patient Advocate FT

    Exceptional Healthcare Inc. 4.0company rating

    Exceptional Healthcare Inc. job in Dallas, TX

    Job DescriptionJob Title: Patient Advocate Reports To: Department Manager FLSA Status: Non-Exempt Company Name: Exceptional Healthcare Summary: The patient advocate is responsible for providing excellent customer service and patient support to all incoming and outgoing patient calls. The main focus is to follow up with patients after their visit to Exceptional Healthcare facilites. Outgoing follow up calls are to ensure that the experience with the facility was positve and pleasant. The calls will also discuss and inform the patient of the Explanation of Benefits they will receive. The patient advocate must be familiar with EOB's in order to assists all patients with questions and concerns. Essential Duties and Responsibilities include the following. • Ensure delivery of excellent customer service through communication and coordinating with team and billing departments to resolve issues. • Conducting outgoing follow up calls to patients in effort to ensure their visit with the facility was a pleasant and positive one. • Informing the patient of the Explanation of Benefits they will receive and explaining the billing process to clear up any questions or concerns. • Responsible for hearing, recording and typing all complaints and submitting them to the complaint sheet. • Report or escalate complaints or patient concerns when needed to facility director. • Performing outgoing follow up calls daily to ensure all patient calls are current for assigned facilities. • Submitting a daily call report to the patient advocate supervisor. Supervisory Responsibilities The Patient Advocate position has no supervisory responsibilities. Position Type and Expected Hours of Work The Patient Advocate position is full-time. Days and hours of work are determined and communicated by the department manager. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. While performing the duties of this job, the noise level in the work environment and job sites can be loud. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to ascend or descend ladders, stairs, scaffolding, ramps, poles, etc. The employee is regularly required to remain stationary, often standing or sitting for prolonged periods. The employee is refugularly required to use hands to finger, handle, or feel; and reach with hands and arms. The employee is occasionally required to assess the accuracy, neatness and thoroughness of the work assigned. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. Travel No travel is expected for this position. The above statements are intended to describe the general nature and level of work being performed by the person assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties, skills, and physical demands and may change at any time with or without notice. Powered by JazzHR n9JTVuTjQM
    $30k-36k yearly est. 26d ago
  • Patient Account Representative FT

    Exceptional Healthcare Inc. 4.0company rating

    Exceptional Healthcare Inc. job in Dallas, TX

    Job Description As a Patient Account Representative, you'll be a guiding force behind efficient patient billing and account management. Your responsibilities will span the entire account lifecycle - from processing claims and collecting payments to resolving issues and addressing patient inquiries with empathy and clarity. Day-to-day, you'll leverage your expertise to: - Process and manage patient claims accurately and efficiently - Collect payments, negotiate overdue balances, and assist with repayment structures - Generate bills and explain insurance benefits to patients - Resolve account-related issues promptly with patients and insurance companies To thrive in this role, you'll need: - A High School Diploma or GED and relevant experience in medical billing, collections and customer service. - Computer proficiency with EMRs and Microsoft Office Suite - Excel, Word, Outlook - Strong understanding of insurance reimbursement procedures and revenue cycle process - Good analytical skills and a firm grasp of calculations and medical terminology - Exceptional verbal and written communication abilities (English a must; Spanish a plus) - Ability to work well independently with limited supervision - Time management and organization to juggle multiple accounts - Willingness to work claims, appeals and denials to positive outcomes (40-50 accounts per day) - Communicate to leadership management areas of concern or areas of improvement - Update patient demographic information and initiate account adjustments - Ability to work for extended periods of time on a computer More than just a financial coordinator, you'll be a trusted advisor, guiding patients through the often-complex realm of healthcare finances. Join our team and make a tangible difference in patients' lives. Why work for Us? We are on the cutting edge of the micro hospital trend in health care, a combination of ER, diagnostic and inpatient services that brings large health care services to the communities it serves. We are a smaller and more agile organization. You aren't just a number. We value our employees and treat them accordingly. Powered by JazzHR WYLUf5ua0j
    $33k-42k yearly est. 26d ago
  • Independent Dispute Resolution (IDR) Claims/OON Specialist

    Exceptional Healthcare Inc. 4.0company rating

    Exceptional Healthcare Inc. job in Dallas, TX

    Job Description Job Summary: We are seeking an experienced and highly motivated Independent Dispute Resolution (IDR) Claims / OON Specialist to join our team. This role requires expertise in medical billing, collection, and appeals and a strong understanding of dispute resolution processes. The ideal candidate will be responsible for managing and resolving medical billing disputes efficiently and in compliance with regulatory requirements. The Independent Dispute Resolution (IDR) Claims / OON Representative needs to assist in managing claims disputes under the No Surprises Act. This position requires an in-depth understanding of healthcare billing, regulations, and dispute resolution processes, ensuring compliance with the No Surprises Act and protecting patients from surprise medical bills. As an IDR Representative, you will be responsible for managing disputes between healthcare providers and insurers, determining the appropriate payment amounts for out-of-network services, and working to resolve disputes efficiently and effectively. This is a key role in helping ensure fair and transparent billing practices by federal regulations. --- Job Responsibilities/Duties: · Review and resolve medical billing, collection, and appeals disputes. · Work with insurance companies, medical providers, and other stakeholders to resolve claims. · Ensure compliance with all federal and state regulations in dispute resolution. · Communicate effectively with all parties to facilitate the resolution of claims. · Maintain accurate documentation of dispute resolution processes and outcomes. · Prepare and submit required reports and documentation promptly. · Proven experience with medical billing, collections, and appeals processes. · Strong understanding of medical billing codes and regulations. · Excellent communication and negotiation skills. · Strong attention to detail and organizational abilities. · Ability to work independently and as part of a team. · Ability to handle complex and sensitive information with confidentiality and professionalism. Qualifications & Experience: · Experience with State or Federal Independent Dispute Resolution processes (e.g., TDI, NSA). · Familiarity with industry regulations and dispute resolution protocols. · Proficiency with medical coding, billing systems, and healthcare software. EDUCATION / EXPERIENCE · High School Diploma or equivalent required. · Associate's or Bachelor's degree in healthcare administration, business, or related field is preferred. · Minimum of 3 years of experience in medical billing, collections, and appeals. · Demonstrated experience in dispute resolution, preferably in a healthcare setting. PHYSICAL DEMANDS · Requires visual acuity to inspect and analyze work close to the eyes and ability to hear sound with or without correction; Ability to climb, stoop, kneel, reach, stand, walk pull, push lift, and able to exert up to 40 pounds of force occasionally and/or up to 10 pounds of force constantly to move objects. · Moderate physical activity, performing somewhat strenuous daily activities of a primarily administrative nature. · The physical demands for this position include adequate vision, hearing, and repetitive motion. · Ascending or descending stairs, ramps, and the like, using feet and legs and/or hands and arms. · Substantial movements (motion) of the wrist, hands, and/or fingers in a repetitive manner - Bending legs downward and forward by bending leg and spine - Standing, particularly for sustained periods of time. Using upper extremities to exert force to draw, drag, haul or tug objects in a sustained motion. · Raising objects from a lower to a higher position or moving object horizontally from position to position WORK CONDITIONS • While performing the duties of this job, the employee is frequently required to stand, walk, sit, reach with hands and arms, and talk or hear. • The employee is occasionally required to stoop, kneel, crouch, or crawl and taste or smell. • The employee is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures, transcribing, and viewing a computer terminal. Powered by JazzHR VgEbbgqQXs
    $30k-44k yearly est. 8d ago
  • Patient Account Representative FT

    Exceptional Healthcare 4.0company rating

    Exceptional Healthcare job in Dallas, TX

    As a Patient Account Representative, you'll be a guiding force behind efficient patient billing and account management. Your responsibilities will span the entire account lifecycle - from processing claims and collecting payments to resolving issues and addressing patient inquiries with empathy and clarity. Day-to-day, you'll leverage your expertise to: - Process and manage patient claims accurately and efficiently - Collect payments, negotiate overdue balances, and assist with repayment structures - Generate bills and explain insurance benefits to patients - Resolve account-related issues promptly with patients and insurance companies To thrive in this role, you'll need: - A High School Diploma or GED and relevant experience in medical billing, collections and customer service. - Computer proficiency with EMRs and Microsoft Office Suite - Excel, Word, Outlook - Strong understanding of insurance reimbursement procedures and revenue cycle process - Good analytical skills and a firm grasp of calculations and medical terminology - Exceptional verbal and written communication abilities (English a must; Spanish a plus) - Ability to work well independently with limited supervision - Time management and organization to juggle multiple accounts - Willingness to work claims, appeals and denials to positive outcomes (40-50 accounts per day) - Communicate to leadership management areas of concern or areas of improvement - Update patient demographic information and initiate account adjustments - Ability to work for extended periods of time on a computer More than just a financial coordinator, you'll be a trusted advisor, guiding patients through the often-complex realm of healthcare finances. Join our team and make a tangible difference in patients' lives. Why work for Us? We are on the cutting edge of the micro hospital trend in health care, a combination of ER, diagnostic and inpatient services that brings large health care services to the communities it serves. We are a smaller and more agile organization. You aren't just a number. We value our employees and treat them accordingly.
    $33k-42k yearly est. Auto-Apply 60d+ ago

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