-
Description & Requirements
Maximus is looking for a Fin Proc Clerk III who will work on assignments that are moderately difficult, requiring judgement in resolving issues.
Prepare account reconciliations and various analyses supporting month end/quarter end financials, and help to ensure the integrity of accounting/financial data.
Essential Duties and Responsibilities:
- Works on assignments that are moderately difficult, requiring judgement in resolving issues.
- Prepare account reconciliations and various analyses supporting month end/quarter end financials, and help to ensure the integrity of accounting/financial data.
Additional Requirements as per contract/client:
* Must reside in the U.S.
* Must be a U.S.
citizen.
* Must be able to pass a criminal background check.
* Must not be delinquent or in default on any federal student loans.
* Employment and continued employment are contingent upon obtaining and maintaining a favorable clearance.
Final suitability determination is the sole discretion of the Department of Education.
* Obtaining and Maintaining a PIV-I card is a requirement of this position.
PIV-I cards must be picked up in person.
If applicable, new and existing employees may need to travel via car, train, or plane to a designated location to pick up their new or replacement PIV-I card.
Any travel expenses will be paid for by Maximus.
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with Associates degree and/or 2-4 years of experience.
- May have additional training or education in area of specialization.
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country.
We're proud of our connections to organizations dedicated to serving veterans and their families.
If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you.
A committed and diverse workforce is our most important resource.
Maximus is an Affirmative Action/Equal Opportunity Employer.
Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.
....Read more...
Type: Permanent Location: Los Angeles, US-CA
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:45
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Description & Requirements
Maximus is looking for a Fin Proc Clerk III who will work on assignments that are moderately difficult, requiring judgement in resolving issues.
Prepare account reconciliations and various analyses supporting month end/quarter end financials, and help to ensure the integrity of accounting/financial data.
Essential Duties and Responsibilities:
- Works on assignments that are moderately difficult, requiring judgement in resolving issues.
- Prepare account reconciliations and various analyses supporting month end/quarter end financials, and help to ensure the integrity of accounting/financial data.
Additional Requirements as per contract/client:
* Must reside in the U.S.
* Must be a U.S.
citizen.
* Must be able to pass a criminal background check.
* Must not be delinquent or in default on any federal student loans.
* Employment and continued employment are contingent upon obtaining and maintaining a favorable clearance.
Final suitability determination is the sole discretion of the Department of Education.
* Obtaining and Maintaining a PIV-I card is a requirement of this position.
PIV-I cards must be picked up in person.
If applicable, new and existing employees may need to travel via car, train, or plane to a designated location to pick up their new or replacement PIV-I card.
Any travel expenses will be paid for by Maximus.
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with Associates degree and/or 2-4 years of experience.
- May have additional training or education in area of specialization.
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country.
We're proud of our connections to organizations dedicated to serving veterans and their families.
If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you.
A committed and diverse workforce is our most important resource.
Maximus is an Affirmative Action/Equal Opportunity Employer.
Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.
....Read more...
Type: Permanent Location: Fort Smith, US-AR
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:43
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Description & Requirements
Maximus is looking for a Fin Proc Clerk III who will work on assignments that are moderately difficult, requiring judgement in resolving issues.
Prepare account reconciliations and various analyses supporting month end/quarter end financials, and help to ensure the integrity of accounting/financial data.
Essential Duties and Responsibilities:
- Works on assignments that are moderately difficult, requiring judgement in resolving issues.
- Prepare account reconciliations and various analyses supporting month end/quarter end financials, and help to ensure the integrity of accounting/financial data.
Additional Requirements as per contract/client:
* Must reside in the U.S.
* Must be a U.S.
citizen.
* Must be able to pass a criminal background check.
* Must not be delinquent or in default on any federal student loans.
* Employment and continued employment are contingent upon obtaining and maintaining a favorable clearance.
Final suitability determination is the sole discretion of the Department of Education.
* Obtaining and Maintaining a PIV-I card is a requirement of this position.
PIV-I cards must be picked up in person.
If applicable, new and existing employees may need to travel via car, train, or plane to a designated location to pick up their new or replacement PIV-I card.
Any travel expenses will be paid for by Maximus.
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with Associates degree and/or 2-4 years of experience.
- May have additional training or education in area of specialization.
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country.
We're proud of our connections to organizations dedicated to serving veterans and their families.
If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you.
A committed and diverse workforce is our most important resource.
Maximus is an Affirmative Action/Equal Opportunity Employer.
Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.
....Read more...
Type: Permanent Location: Tucson, US-AZ
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:42
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Description & Requirements
Maximus is looking for a Fin Proc Clerk III who will work on assignments that are moderately difficult, requiring judgement in resolving issues.
Prepare account reconciliations and various analyses supporting month end/quarter end financials, and help to ensure the integrity of accounting/financial data.
Essential Duties and Responsibilities:
- Works on assignments that are moderately difficult, requiring judgement in resolving issues.
- Prepare account reconciliations and various analyses supporting month end/quarter end financials, and help to ensure the integrity of accounting/financial data.
Additional Requirements as per contract/client:
* Must reside in the U.S.
* Must be a U.S.
citizen.
* Must be able to pass a criminal background check.
* Must not be delinquent or in default on any federal student loans.
* Employment and continued employment are contingent upon obtaining and maintaining a favorable clearance.
Final suitability determination is the sole discretion of the Department of Education.
* Obtaining and Maintaining a PIV-I card is a requirement of this position.
PIV-I cards must be picked up in person.
If applicable, new and existing employees may need to travel via car, train, or plane to a designated location to pick up their new or replacement PIV-I card.
Any travel expenses will be paid for by Maximus.
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with Associates degree and/or 2-4 years of experience.
- May have additional training or education in area of specialization.
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country.
We're proud of our connections to organizations dedicated to serving veterans and their families.
If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you.
A committed and diverse workforce is our most important resource.
Maximus is an Affirmative Action/Equal Opportunity Employer.
Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.
....Read more...
Type: Permanent Location: San Francisco, US-CA
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:41
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Description & Requirements
Maximus is looking to hire a Senior Certified Coding Specialist to support our Office of Inspector General (OIG) program.
This is a fully remote position.
Why Maximus?
* Fully Remote Position
* Paid Time Off and Holidays
* Work/Life Balance
* Tuition Reimbursement
Work schedule will align to the Central Time Zone.
Essential Duties and Responsibilities:
- Provides advanced clinical inquiry responses (verbal and written) to health related inquiries from consumers, educators or medical/health professionals.
- Provides medical subject matter expertise.
- Performs advanced database searches.
- Composes documents, reports, and correspondence.
- Documents all incoming inquiries.
- May assist in training and leading subordinate specialists.
- Provides routine reports on the functions supported by the team.
Project-Specific Essential Job Duties:
* Audit inpatient, outpatient, and physician medical records to ensure compliance with the Medical Advantage Risk Adjustment standards including abstraction and assignment of appropriate ICD-9-CM and ICD-10-CM codes based on medical record documentation and clinical findings
* Expertise in the assignment of ICD-9-CM and ICD-10-CM codes and the correct application of the Official Guidelines for Coding and Reporting for each type of service (inpatient and outpatient)
* Apply knowledge of inpatient and outpatient ICD diagnosis code guidelines and clinical documentation requirements to assign HCCs
* Determine if code assignments submitted by Medicare Advantage Plans that result in Hierarchical condition categories (HCCs) are accurate thereby affecting the risk adjustment payment calculations made to Medicare Advantage Plans/Organizations
* Thorough knowledge of Risk Adjustment Diagnosis Validation (RADV) coding rules and requirements
* Ability to author clear and concise rationales that provide defensible support of decisions
* Collaborate with physicians and other coders to address issues were guidance and documentation are not clear
* Accurately enter abstracted data and codes into a system and validate data entered
* Research correct coding practices, clearly document and share findings with others
* Recommend and suggest improvements to assigned projects
* Communicate with physicians and other team members either through discussion or in writing (e.g., formal queries) regarding missing, unclear, or conflicting health record documentation and policies to obtain clarification to provide accurate decisions
* Conduct follow-up re-evaluation of coding decisions to determine accuracy and make necessary revisions and adjustments to clarify decision rationales
* Act as a consultant to client and make recommendations based on experience performing audits
* Attend meetings with client when necessary to provide coding expertise when requested by Project Manager
* Attend kick-off meetings ...
....Read more...
Type: Permanent Location: Charleston, US-WV
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:40
-
Description & Requirements
Maximus is looking to hire a Senior Certified Coding Specialist to support our Office of Inspector General (OIG) program.
This is a fully remote position.
Why Maximus?
* Fully Remote Position
* Paid Time Off and Holidays
* Work/Life Balance
* Tuition Reimbursement
Work schedule will align to the Central Time Zone.
Essential Duties and Responsibilities:
- Provides advanced clinical inquiry responses (verbal and written) to health related inquiries from consumers, educators or medical/health professionals.
- Provides medical subject matter expertise.
- Performs advanced database searches.
- Composes documents, reports, and correspondence.
- Documents all incoming inquiries.
- May assist in training and leading subordinate specialists.
- Provides routine reports on the functions supported by the team.
Project-Specific Essential Job Duties:
* Audit inpatient, outpatient, and physician medical records to ensure compliance with the Medical Advantage Risk Adjustment standards including abstraction and assignment of appropriate ICD-9-CM and ICD-10-CM codes based on medical record documentation and clinical findings
* Expertise in the assignment of ICD-9-CM and ICD-10-CM codes and the correct application of the Official Guidelines for Coding and Reporting for each type of service (inpatient and outpatient)
* Apply knowledge of inpatient and outpatient ICD diagnosis code guidelines and clinical documentation requirements to assign HCCs
* Determine if code assignments submitted by Medicare Advantage Plans that result in Hierarchical condition categories (HCCs) are accurate thereby affecting the risk adjustment payment calculations made to Medicare Advantage Plans/Organizations
* Thorough knowledge of Risk Adjustment Diagnosis Validation (RADV) coding rules and requirements
* Ability to author clear and concise rationales that provide defensible support of decisions
* Collaborate with physicians and other coders to address issues were guidance and documentation are not clear
* Accurately enter abstracted data and codes into a system and validate data entered
* Research correct coding practices, clearly document and share findings with others
* Recommend and suggest improvements to assigned projects
* Communicate with physicians and other team members either through discussion or in writing (e.g., formal queries) regarding missing, unclear, or conflicting health record documentation and policies to obtain clarification to provide accurate decisions
* Conduct follow-up re-evaluation of coding decisions to determine accuracy and make necessary revisions and adjustments to clarify decision rationales
* Act as a consultant to client and make recommendations based on experience performing audits
* Attend meetings with client when necessary to provide coding expertise when requested by Project Manager
* Attend kick-off meetings ...
....Read more...
Type: Permanent Location: Cheyenne, US-WY
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:39
-
Description & Requirements
Maximus is looking for a Fin Proc Clerk III who will work on assignments that are moderately difficult, requiring judgement in resolving issues.
Prepare account reconciliations and various analyses supporting month end/quarter end financials, and help to ensure the integrity of accounting/financial data.
Essential Duties and Responsibilities:
- Works on assignments that are moderately difficult, requiring judgement in resolving issues.
- Prepare account reconciliations and various analyses supporting month end/quarter end financials, and help to ensure the integrity of accounting/financial data.
Additional Requirements as per contract/client:
* Must reside in the U.S.
* Must be a U.S.
citizen.
* Must be able to pass a criminal background check.
* Must not be delinquent or in default on any federal student loans.
* Employment and continued employment are contingent upon obtaining and maintaining a favorable clearance.
Final suitability determination is the sole discretion of the Department of Education.
* Obtaining and Maintaining a PIV-I card is a requirement of this position.
PIV-I cards must be picked up in person.
If applicable, new and existing employees may need to travel via car, train, or plane to a designated location to pick up their new or replacement PIV-I card.
Any travel expenses will be paid for by Maximus.
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with Associates degree and/or 2-4 years of experience.
- May have additional training or education in area of specialization.
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country.
We're proud of our connections to organizations dedicated to serving veterans and their families.
If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you.
A committed and diverse workforce is our most important resource.
Maximus is an Affirmative Action/Equal Opportunity Employer.
Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.
....Read more...
Type: Permanent Location: Montgomery, US-AL
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:38
-
Description & Requirements
Maximus is looking to hire a Senior Certified Coding Specialist to support our Office of Inspector General (OIG) program.
This is a fully remote position.
Why Maximus?
* Fully Remote Position
* Paid Time Off and Holidays
* Work/Life Balance
* Tuition Reimbursement
Work schedule will align to the Central Time Zone.
Essential Duties and Responsibilities:
- Provides advanced clinical inquiry responses (verbal and written) to health related inquiries from consumers, educators or medical/health professionals.
- Provides medical subject matter expertise.
- Performs advanced database searches.
- Composes documents, reports, and correspondence.
- Documents all incoming inquiries.
- May assist in training and leading subordinate specialists.
- Provides routine reports on the functions supported by the team.
Project-Specific Essential Job Duties:
* Audit inpatient, outpatient, and physician medical records to ensure compliance with the Medical Advantage Risk Adjustment standards including abstraction and assignment of appropriate ICD-9-CM and ICD-10-CM codes based on medical record documentation and clinical findings
* Expertise in the assignment of ICD-9-CM and ICD-10-CM codes and the correct application of the Official Guidelines for Coding and Reporting for each type of service (inpatient and outpatient)
* Apply knowledge of inpatient and outpatient ICD diagnosis code guidelines and clinical documentation requirements to assign HCCs
* Determine if code assignments submitted by Medicare Advantage Plans that result in Hierarchical condition categories (HCCs) are accurate thereby affecting the risk adjustment payment calculations made to Medicare Advantage Plans/Organizations
* Thorough knowledge of Risk Adjustment Diagnosis Validation (RADV) coding rules and requirements
* Ability to author clear and concise rationales that provide defensible support of decisions
* Collaborate with physicians and other coders to address issues were guidance and documentation are not clear
* Accurately enter abstracted data and codes into a system and validate data entered
* Research correct coding practices, clearly document and share findings with others
* Recommend and suggest improvements to assigned projects
* Communicate with physicians and other team members either through discussion or in writing (e.g., formal queries) regarding missing, unclear, or conflicting health record documentation and policies to obtain clarification to provide accurate decisions
* Conduct follow-up re-evaluation of coding decisions to determine accuracy and make necessary revisions and adjustments to clarify decision rationales
* Act as a consultant to client and make recommendations based on experience performing audits
* Attend meetings with client when necessary to provide coding expertise when requested by Project Manager
* Attend kick-off meetings ...
....Read more...
Type: Permanent Location: Milwaukee, US-WI
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:37
-
Description & Requirements
Maximus is looking to hire a Senior Certified Coding Specialist to support our Office of Inspector General (OIG) program.
This is a fully remote position.
Why Maximus?
* Fully Remote Position
* Paid Time Off and Holidays
* Work/Life Balance
* Tuition Reimbursement
Work schedule will align to the Central Time Zone.
Essential Duties and Responsibilities:
- Provides advanced clinical inquiry responses (verbal and written) to health related inquiries from consumers, educators or medical/health professionals.
- Provides medical subject matter expertise.
- Performs advanced database searches.
- Composes documents, reports, and correspondence.
- Documents all incoming inquiries.
- May assist in training and leading subordinate specialists.
- Provides routine reports on the functions supported by the team.
Project-Specific Essential Job Duties:
* Audit inpatient, outpatient, and physician medical records to ensure compliance with the Medical Advantage Risk Adjustment standards including abstraction and assignment of appropriate ICD-9-CM and ICD-10-CM codes based on medical record documentation and clinical findings
* Expertise in the assignment of ICD-9-CM and ICD-10-CM codes and the correct application of the Official Guidelines for Coding and Reporting for each type of service (inpatient and outpatient)
* Apply knowledge of inpatient and outpatient ICD diagnosis code guidelines and clinical documentation requirements to assign HCCs
* Determine if code assignments submitted by Medicare Advantage Plans that result in Hierarchical condition categories (HCCs) are accurate thereby affecting the risk adjustment payment calculations made to Medicare Advantage Plans/Organizations
* Thorough knowledge of Risk Adjustment Diagnosis Validation (RADV) coding rules and requirements
* Ability to author clear and concise rationales that provide defensible support of decisions
* Collaborate with physicians and other coders to address issues were guidance and documentation are not clear
* Accurately enter abstracted data and codes into a system and validate data entered
* Research correct coding practices, clearly document and share findings with others
* Recommend and suggest improvements to assigned projects
* Communicate with physicians and other team members either through discussion or in writing (e.g., formal queries) regarding missing, unclear, or conflicting health record documentation and policies to obtain clarification to provide accurate decisions
* Conduct follow-up re-evaluation of coding decisions to determine accuracy and make necessary revisions and adjustments to clarify decision rationales
* Act as a consultant to client and make recommendations based on experience performing audits
* Attend meetings with client when necessary to provide coding expertise when requested by Project Manager
* Attend kick-off meetings ...
....Read more...
Type: Permanent Location: Eau Claire, US-WI
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:35
-
Description & Requirements
Maximus is looking for a Fin Proc Clerk III who will work on assignments that are moderately difficult, requiring judgement in resolving issues.
Prepare account reconciliations and various analyses supporting month end/quarter end financials, and help to ensure the integrity of accounting/financial data.
Essential Duties and Responsibilities:
- Works on assignments that are moderately difficult, requiring judgement in resolving issues.
- Prepare account reconciliations and various analyses supporting month end/quarter end financials, and help to ensure the integrity of accounting/financial data.
Additional Requirements as per contract/client:
* Must reside in the U.S.
* Must be a U.S.
citizen.
* Must be able to pass a criminal background check.
* Must not be delinquent or in default on any federal student loans.
* Employment and continued employment are contingent upon obtaining and maintaining a favorable clearance.
Final suitability determination is the sole discretion of the Department of Education.
* Obtaining and Maintaining a PIV-I card is a requirement of this position.
PIV-I cards must be picked up in person.
If applicable, new and existing employees may need to travel via car, train, or plane to a designated location to pick up their new or replacement PIV-I card.
Any travel expenses will be paid for by Maximus.
Minimum Requirements
Minimum Requirements:
- High School diploma or equivalent with Associates degree and/or 2-4 years of experience.
- May have additional training or education in area of specialization.
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.
We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country.
We're proud of our connections to organizations dedicated to serving veterans and their families.
If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you.
A committed and diverse workforce is our most important resource.
Maximus is an Affirmative Action/Equal Opportunity Employer.
Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.
....Read more...
Type: Permanent Location: Birmingham, US-AL
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:34
-
Description & Requirements
Maximus is looking to hire a Senior Certified Coding Specialist to support our Office of Inspector General (OIG) program.
This is a fully remote position.
Why Maximus?
* Fully Remote Position
* Paid Time Off and Holidays
* Work/Life Balance
* Tuition Reimbursement
Work schedule will align to the Central Time Zone.
Essential Duties and Responsibilities:
- Provides advanced clinical inquiry responses (verbal and written) to health related inquiries from consumers, educators or medical/health professionals.
- Provides medical subject matter expertise.
- Performs advanced database searches.
- Composes documents, reports, and correspondence.
- Documents all incoming inquiries.
- May assist in training and leading subordinate specialists.
- Provides routine reports on the functions supported by the team.
Project-Specific Essential Job Duties:
* Audit inpatient, outpatient, and physician medical records to ensure compliance with the Medical Advantage Risk Adjustment standards including abstraction and assignment of appropriate ICD-9-CM and ICD-10-CM codes based on medical record documentation and clinical findings
* Expertise in the assignment of ICD-9-CM and ICD-10-CM codes and the correct application of the Official Guidelines for Coding and Reporting for each type of service (inpatient and outpatient)
* Apply knowledge of inpatient and outpatient ICD diagnosis code guidelines and clinical documentation requirements to assign HCCs
* Determine if code assignments submitted by Medicare Advantage Plans that result in Hierarchical condition categories (HCCs) are accurate thereby affecting the risk adjustment payment calculations made to Medicare Advantage Plans/Organizations
* Thorough knowledge of Risk Adjustment Diagnosis Validation (RADV) coding rules and requirements
* Ability to author clear and concise rationales that provide defensible support of decisions
* Collaborate with physicians and other coders to address issues were guidance and documentation are not clear
* Accurately enter abstracted data and codes into a system and validate data entered
* Research correct coding practices, clearly document and share findings with others
* Recommend and suggest improvements to assigned projects
* Communicate with physicians and other team members either through discussion or in writing (e.g., formal queries) regarding missing, unclear, or conflicting health record documentation and policies to obtain clarification to provide accurate decisions
* Conduct follow-up re-evaluation of coding decisions to determine accuracy and make necessary revisions and adjustments to clarify decision rationales
* Act as a consultant to client and make recommendations based on experience performing audits
* Attend meetings with client when necessary to provide coding expertise when requested by Project Manager
* Attend kick-off meetings ...
....Read more...
Type: Permanent Location: Morgantown, US-WV
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:33
-
Description & Requirements
Maximus is looking to hire a Senior Certified Coding Specialist to support our Office of Inspector General (OIG) program.
This is a fully remote position.
Why Maximus?
* Fully Remote Position
* Paid Time Off and Holidays
* Work/Life Balance
* Tuition Reimbursement
Work schedule will align to the Central Time Zone.
Essential Duties and Responsibilities:
- Provides advanced clinical inquiry responses (verbal and written) to health related inquiries from consumers, educators or medical/health professionals.
- Provides medical subject matter expertise.
- Performs advanced database searches.
- Composes documents, reports, and correspondence.
- Documents all incoming inquiries.
- May assist in training and leading subordinate specialists.
- Provides routine reports on the functions supported by the team.
Project-Specific Essential Job Duties:
* Audit inpatient, outpatient, and physician medical records to ensure compliance with the Medical Advantage Risk Adjustment standards including abstraction and assignment of appropriate ICD-9-CM and ICD-10-CM codes based on medical record documentation and clinical findings
* Expertise in the assignment of ICD-9-CM and ICD-10-CM codes and the correct application of the Official Guidelines for Coding and Reporting for each type of service (inpatient and outpatient)
* Apply knowledge of inpatient and outpatient ICD diagnosis code guidelines and clinical documentation requirements to assign HCCs
* Determine if code assignments submitted by Medicare Advantage Plans that result in Hierarchical condition categories (HCCs) are accurate thereby affecting the risk adjustment payment calculations made to Medicare Advantage Plans/Organizations
* Thorough knowledge of Risk Adjustment Diagnosis Validation (RADV) coding rules and requirements
* Ability to author clear and concise rationales that provide defensible support of decisions
* Collaborate with physicians and other coders to address issues were guidance and documentation are not clear
* Accurately enter abstracted data and codes into a system and validate data entered
* Research correct coding practices, clearly document and share findings with others
* Recommend and suggest improvements to assigned projects
* Communicate with physicians and other team members either through discussion or in writing (e.g., formal queries) regarding missing, unclear, or conflicting health record documentation and policies to obtain clarification to provide accurate decisions
* Conduct follow-up re-evaluation of coding decisions to determine accuracy and make necessary revisions and adjustments to clarify decision rationales
* Act as a consultant to client and make recommendations based on experience performing audits
* Attend meetings with client when necessary to provide coding expertise when requested by Project Manager
* Attend kick-off meetings ...
....Read more...
Type: Permanent Location: Rock Springs, US-WY
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:32
-
Description & Requirements
Maximus is looking to hire a Senior Certified Coding Specialist to support our Office of Inspector General (OIG) program.
This is a fully remote position.
Why Maximus?
* Fully Remote Position
* Paid Time Off and Holidays
* Work/Life Balance
* Tuition Reimbursement
Work schedule will align to the Central Time Zone.
Essential Duties and Responsibilities:
- Provides advanced clinical inquiry responses (verbal and written) to health related inquiries from consumers, educators or medical/health professionals.
- Provides medical subject matter expertise.
- Performs advanced database searches.
- Composes documents, reports, and correspondence.
- Documents all incoming inquiries.
- May assist in training and leading subordinate specialists.
- Provides routine reports on the functions supported by the team.
Project-Specific Essential Job Duties:
* Audit inpatient, outpatient, and physician medical records to ensure compliance with the Medical Advantage Risk Adjustment standards including abstraction and assignment of appropriate ICD-9-CM and ICD-10-CM codes based on medical record documentation and clinical findings
* Expertise in the assignment of ICD-9-CM and ICD-10-CM codes and the correct application of the Official Guidelines for Coding and Reporting for each type of service (inpatient and outpatient)
* Apply knowledge of inpatient and outpatient ICD diagnosis code guidelines and clinical documentation requirements to assign HCCs
* Determine if code assignments submitted by Medicare Advantage Plans that result in Hierarchical condition categories (HCCs) are accurate thereby affecting the risk adjustment payment calculations made to Medicare Advantage Plans/Organizations
* Thorough knowledge of Risk Adjustment Diagnosis Validation (RADV) coding rules and requirements
* Ability to author clear and concise rationales that provide defensible support of decisions
* Collaborate with physicians and other coders to address issues were guidance and documentation are not clear
* Accurately enter abstracted data and codes into a system and validate data entered
* Research correct coding practices, clearly document and share findings with others
* Recommend and suggest improvements to assigned projects
* Communicate with physicians and other team members either through discussion or in writing (e.g., formal queries) regarding missing, unclear, or conflicting health record documentation and policies to obtain clarification to provide accurate decisions
* Conduct follow-up re-evaluation of coding decisions to determine accuracy and make necessary revisions and adjustments to clarify decision rationales
* Act as a consultant to client and make recommendations based on experience performing audits
* Attend meetings with client when necessary to provide coding expertise when requested by Project Manager
* Attend kick-off meetings ...
....Read more...
Type: Permanent Location: Richmond, US-VA
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:31
-
Description & Requirements
Maximus is looking to hire a Senior Certified Coding Specialist to support our Office of Inspector General (OIG) program.
This is a fully remote position.
Why Maximus?
* Fully Remote Position
* Paid Time Off and Holidays
* Work/Life Balance
* Tuition Reimbursement
Work schedule will align to the Central Time Zone.
Essential Duties and Responsibilities:
- Provides advanced clinical inquiry responses (verbal and written) to health related inquiries from consumers, educators or medical/health professionals.
- Provides medical subject matter expertise.
- Performs advanced database searches.
- Composes documents, reports, and correspondence.
- Documents all incoming inquiries.
- May assist in training and leading subordinate specialists.
- Provides routine reports on the functions supported by the team.
Project-Specific Essential Job Duties:
* Audit inpatient, outpatient, and physician medical records to ensure compliance with the Medical Advantage Risk Adjustment standards including abstraction and assignment of appropriate ICD-9-CM and ICD-10-CM codes based on medical record documentation and clinical findings
* Expertise in the assignment of ICD-9-CM and ICD-10-CM codes and the correct application of the Official Guidelines for Coding and Reporting for each type of service (inpatient and outpatient)
* Apply knowledge of inpatient and outpatient ICD diagnosis code guidelines and clinical documentation requirements to assign HCCs
* Determine if code assignments submitted by Medicare Advantage Plans that result in Hierarchical condition categories (HCCs) are accurate thereby affecting the risk adjustment payment calculations made to Medicare Advantage Plans/Organizations
* Thorough knowledge of Risk Adjustment Diagnosis Validation (RADV) coding rules and requirements
* Ability to author clear and concise rationales that provide defensible support of decisions
* Collaborate with physicians and other coders to address issues were guidance and documentation are not clear
* Accurately enter abstracted data and codes into a system and validate data entered
* Research correct coding practices, clearly document and share findings with others
* Recommend and suggest improvements to assigned projects
* Communicate with physicians and other team members either through discussion or in writing (e.g., formal queries) regarding missing, unclear, or conflicting health record documentation and policies to obtain clarification to provide accurate decisions
* Conduct follow-up re-evaluation of coding decisions to determine accuracy and make necessary revisions and adjustments to clarify decision rationales
* Act as a consultant to client and make recommendations based on experience performing audits
* Attend meetings with client when necessary to provide coding expertise when requested by Project Manager
* Attend kick-off meetings ...
....Read more...
Type: Permanent Location: Seattle, US-WA
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:30
-
Description & Requirements
Maximus is looking to hire a Senior Certified Coding Specialist to support our Office of Inspector General (OIG) program.
This is a fully remote position.
Why Maximus?
* Fully Remote Position
* Paid Time Off and Holidays
* Work/Life Balance
* Tuition Reimbursement
Work schedule will align to the Central Time Zone.
Essential Duties and Responsibilities:
- Provides advanced clinical inquiry responses (verbal and written) to health related inquiries from consumers, educators or medical/health professionals.
- Provides medical subject matter expertise.
- Performs advanced database searches.
- Composes documents, reports, and correspondence.
- Documents all incoming inquiries.
- May assist in training and leading subordinate specialists.
- Provides routine reports on the functions supported by the team.
Project-Specific Essential Job Duties:
* Audit inpatient, outpatient, and physician medical records to ensure compliance with the Medical Advantage Risk Adjustment standards including abstraction and assignment of appropriate ICD-9-CM and ICD-10-CM codes based on medical record documentation and clinical findings
* Expertise in the assignment of ICD-9-CM and ICD-10-CM codes and the correct application of the Official Guidelines for Coding and Reporting for each type of service (inpatient and outpatient)
* Apply knowledge of inpatient and outpatient ICD diagnosis code guidelines and clinical documentation requirements to assign HCCs
* Determine if code assignments submitted by Medicare Advantage Plans that result in Hierarchical condition categories (HCCs) are accurate thereby affecting the risk adjustment payment calculations made to Medicare Advantage Plans/Organizations
* Thorough knowledge of Risk Adjustment Diagnosis Validation (RADV) coding rules and requirements
* Ability to author clear and concise rationales that provide defensible support of decisions
* Collaborate with physicians and other coders to address issues were guidance and documentation are not clear
* Accurately enter abstracted data and codes into a system and validate data entered
* Research correct coding practices, clearly document and share findings with others
* Recommend and suggest improvements to assigned projects
* Communicate with physicians and other team members either through discussion or in writing (e.g., formal queries) regarding missing, unclear, or conflicting health record documentation and policies to obtain clarification to provide accurate decisions
* Conduct follow-up re-evaluation of coding decisions to determine accuracy and make necessary revisions and adjustments to clarify decision rationales
* Act as a consultant to client and make recommendations based on experience performing audits
* Attend meetings with client when necessary to provide coding expertise when requested by Project Manager
* Attend kick-off meetings ...
....Read more...
Type: Permanent Location: Tysons, US-VA
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:29
-
Description & Requirements
Maximus is looking to hire a Senior Certified Coding Specialist to support our Office of Inspector General (OIG) program.
This is a fully remote position.
Why Maximus?
* Fully Remote Position
* Paid Time Off and Holidays
* Work/Life Balance
* Tuition Reimbursement
Work schedule will align to the Central Time Zone.
Essential Duties and Responsibilities:
- Provides advanced clinical inquiry responses (verbal and written) to health related inquiries from consumers, educators or medical/health professionals.
- Provides medical subject matter expertise.
- Performs advanced database searches.
- Composes documents, reports, and correspondence.
- Documents all incoming inquiries.
- May assist in training and leading subordinate specialists.
- Provides routine reports on the functions supported by the team.
Project-Specific Essential Job Duties:
* Audit inpatient, outpatient, and physician medical records to ensure compliance with the Medical Advantage Risk Adjustment standards including abstraction and assignment of appropriate ICD-9-CM and ICD-10-CM codes based on medical record documentation and clinical findings
* Expertise in the assignment of ICD-9-CM and ICD-10-CM codes and the correct application of the Official Guidelines for Coding and Reporting for each type of service (inpatient and outpatient)
* Apply knowledge of inpatient and outpatient ICD diagnosis code guidelines and clinical documentation requirements to assign HCCs
* Determine if code assignments submitted by Medicare Advantage Plans that result in Hierarchical condition categories (HCCs) are accurate thereby affecting the risk adjustment payment calculations made to Medicare Advantage Plans/Organizations
* Thorough knowledge of Risk Adjustment Diagnosis Validation (RADV) coding rules and requirements
* Ability to author clear and concise rationales that provide defensible support of decisions
* Collaborate with physicians and other coders to address issues were guidance and documentation are not clear
* Accurately enter abstracted data and codes into a system and validate data entered
* Research correct coding practices, clearly document and share findings with others
* Recommend and suggest improvements to assigned projects
* Communicate with physicians and other team members either through discussion or in writing (e.g., formal queries) regarding missing, unclear, or conflicting health record documentation and policies to obtain clarification to provide accurate decisions
* Conduct follow-up re-evaluation of coding decisions to determine accuracy and make necessary revisions and adjustments to clarify decision rationales
* Act as a consultant to client and make recommendations based on experience performing audits
* Attend meetings with client when necessary to provide coding expertise when requested by Project Manager
* Attend kick-off meetings ...
....Read more...
Type: Permanent Location: St. George, US-UT
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:28
-
Description & Requirements
Maximus is looking to hire a Senior Certified Coding Specialist to support our Office of Inspector General (OIG) program.
This is a fully remote position.
Why Maximus?
* Fully Remote Position
* Paid Time Off and Holidays
* Work/Life Balance
* Tuition Reimbursement
Work schedule will align to the Central Time Zone.
Essential Duties and Responsibilities:
- Provides advanced clinical inquiry responses (verbal and written) to health related inquiries from consumers, educators or medical/health professionals.
- Provides medical subject matter expertise.
- Performs advanced database searches.
- Composes documents, reports, and correspondence.
- Documents all incoming inquiries.
- May assist in training and leading subordinate specialists.
- Provides routine reports on the functions supported by the team.
Project-Specific Essential Job Duties:
* Audit inpatient, outpatient, and physician medical records to ensure compliance with the Medical Advantage Risk Adjustment standards including abstraction and assignment of appropriate ICD-9-CM and ICD-10-CM codes based on medical record documentation and clinical findings
* Expertise in the assignment of ICD-9-CM and ICD-10-CM codes and the correct application of the Official Guidelines for Coding and Reporting for each type of service (inpatient and outpatient)
* Apply knowledge of inpatient and outpatient ICD diagnosis code guidelines and clinical documentation requirements to assign HCCs
* Determine if code assignments submitted by Medicare Advantage Plans that result in Hierarchical condition categories (HCCs) are accurate thereby affecting the risk adjustment payment calculations made to Medicare Advantage Plans/Organizations
* Thorough knowledge of Risk Adjustment Diagnosis Validation (RADV) coding rules and requirements
* Ability to author clear and concise rationales that provide defensible support of decisions
* Collaborate with physicians and other coders to address issues were guidance and documentation are not clear
* Accurately enter abstracted data and codes into a system and validate data entered
* Research correct coding practices, clearly document and share findings with others
* Recommend and suggest improvements to assigned projects
* Communicate with physicians and other team members either through discussion or in writing (e.g., formal queries) regarding missing, unclear, or conflicting health record documentation and policies to obtain clarification to provide accurate decisions
* Conduct follow-up re-evaluation of coding decisions to determine accuracy and make necessary revisions and adjustments to clarify decision rationales
* Act as a consultant to client and make recommendations based on experience performing audits
* Attend meetings with client when necessary to provide coding expertise when requested by Project Manager
* Attend kick-off meetings ...
....Read more...
Type: Permanent Location: Burlington, US-VT
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:27
-
Description & Requirements
Maximus is looking to hire a Senior Certified Coding Specialist to support our Office of Inspector General (OIG) program.
This is a fully remote position.
Why Maximus?
* Fully Remote Position
* Paid Time Off and Holidays
* Work/Life Balance
* Tuition Reimbursement
Work schedule will align to the Central Time Zone.
Essential Duties and Responsibilities:
- Provides advanced clinical inquiry responses (verbal and written) to health related inquiries from consumers, educators or medical/health professionals.
- Provides medical subject matter expertise.
- Performs advanced database searches.
- Composes documents, reports, and correspondence.
- Documents all incoming inquiries.
- May assist in training and leading subordinate specialists.
- Provides routine reports on the functions supported by the team.
Project-Specific Essential Job Duties:
* Audit inpatient, outpatient, and physician medical records to ensure compliance with the Medical Advantage Risk Adjustment standards including abstraction and assignment of appropriate ICD-9-CM and ICD-10-CM codes based on medical record documentation and clinical findings
* Expertise in the assignment of ICD-9-CM and ICD-10-CM codes and the correct application of the Official Guidelines for Coding and Reporting for each type of service (inpatient and outpatient)
* Apply knowledge of inpatient and outpatient ICD diagnosis code guidelines and clinical documentation requirements to assign HCCs
* Determine if code assignments submitted by Medicare Advantage Plans that result in Hierarchical condition categories (HCCs) are accurate thereby affecting the risk adjustment payment calculations made to Medicare Advantage Plans/Organizations
* Thorough knowledge of Risk Adjustment Diagnosis Validation (RADV) coding rules and requirements
* Ability to author clear and concise rationales that provide defensible support of decisions
* Collaborate with physicians and other coders to address issues were guidance and documentation are not clear
* Accurately enter abstracted data and codes into a system and validate data entered
* Research correct coding practices, clearly document and share findings with others
* Recommend and suggest improvements to assigned projects
* Communicate with physicians and other team members either through discussion or in writing (e.g., formal queries) regarding missing, unclear, or conflicting health record documentation and policies to obtain clarification to provide accurate decisions
* Conduct follow-up re-evaluation of coding decisions to determine accuracy and make necessary revisions and adjustments to clarify decision rationales
* Act as a consultant to client and make recommendations based on experience performing audits
* Attend meetings with client when necessary to provide coding expertise when requested by Project Manager
* Attend kick-off meetings ...
....Read more...
Type: Permanent Location: Roanoke, US-VA
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:26
-
Description & Requirements
Maximus is looking to hire a Senior Certified Coding Specialist to support our Office of Inspector General (OIG) program.
This is a fully remote position.
Why Maximus?
* Fully Remote Position
* Paid Time Off and Holidays
* Work/Life Balance
* Tuition Reimbursement
Work schedule will align to the Central Time Zone.
Essential Duties and Responsibilities:
- Provides advanced clinical inquiry responses (verbal and written) to health related inquiries from consumers, educators or medical/health professionals.
- Provides medical subject matter expertise.
- Performs advanced database searches.
- Composes documents, reports, and correspondence.
- Documents all incoming inquiries.
- May assist in training and leading subordinate specialists.
- Provides routine reports on the functions supported by the team.
Project-Specific Essential Job Duties:
* Audit inpatient, outpatient, and physician medical records to ensure compliance with the Medical Advantage Risk Adjustment standards including abstraction and assignment of appropriate ICD-9-CM and ICD-10-CM codes based on medical record documentation and clinical findings
* Expertise in the assignment of ICD-9-CM and ICD-10-CM codes and the correct application of the Official Guidelines for Coding and Reporting for each type of service (inpatient and outpatient)
* Apply knowledge of inpatient and outpatient ICD diagnosis code guidelines and clinical documentation requirements to assign HCCs
* Determine if code assignments submitted by Medicare Advantage Plans that result in Hierarchical condition categories (HCCs) are accurate thereby affecting the risk adjustment payment calculations made to Medicare Advantage Plans/Organizations
* Thorough knowledge of Risk Adjustment Diagnosis Validation (RADV) coding rules and requirements
* Ability to author clear and concise rationales that provide defensible support of decisions
* Collaborate with physicians and other coders to address issues were guidance and documentation are not clear
* Accurately enter abstracted data and codes into a system and validate data entered
* Research correct coding practices, clearly document and share findings with others
* Recommend and suggest improvements to assigned projects
* Communicate with physicians and other team members either through discussion or in writing (e.g., formal queries) regarding missing, unclear, or conflicting health record documentation and policies to obtain clarification to provide accurate decisions
* Conduct follow-up re-evaluation of coding decisions to determine accuracy and make necessary revisions and adjustments to clarify decision rationales
* Act as a consultant to client and make recommendations based on experience performing audits
* Attend meetings with client when necessary to provide coding expertise when requested by Project Manager
* Attend kick-off meetings ...
....Read more...
Type: Permanent Location: Bennington, US-VT
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:25
-
Description & Requirements
Maximus is looking to hire a Senior Certified Coding Specialist to support our Office of Inspector General (OIG) program.
This is a fully remote position.
Why Maximus?
* Fully Remote Position
* Paid Time Off and Holidays
* Work/Life Balance
* Tuition Reimbursement
Work schedule will align to the Central Time Zone.
Essential Duties and Responsibilities:
- Provides advanced clinical inquiry responses (verbal and written) to health related inquiries from consumers, educators or medical/health professionals.
- Provides medical subject matter expertise.
- Performs advanced database searches.
- Composes documents, reports, and correspondence.
- Documents all incoming inquiries.
- May assist in training and leading subordinate specialists.
- Provides routine reports on the functions supported by the team.
Project-Specific Essential Job Duties:
* Audit inpatient, outpatient, and physician medical records to ensure compliance with the Medical Advantage Risk Adjustment standards including abstraction and assignment of appropriate ICD-9-CM and ICD-10-CM codes based on medical record documentation and clinical findings
* Expertise in the assignment of ICD-9-CM and ICD-10-CM codes and the correct application of the Official Guidelines for Coding and Reporting for each type of service (inpatient and outpatient)
* Apply knowledge of inpatient and outpatient ICD diagnosis code guidelines and clinical documentation requirements to assign HCCs
* Determine if code assignments submitted by Medicare Advantage Plans that result in Hierarchical condition categories (HCCs) are accurate thereby affecting the risk adjustment payment calculations made to Medicare Advantage Plans/Organizations
* Thorough knowledge of Risk Adjustment Diagnosis Validation (RADV) coding rules and requirements
* Ability to author clear and concise rationales that provide defensible support of decisions
* Collaborate with physicians and other coders to address issues were guidance and documentation are not clear
* Accurately enter abstracted data and codes into a system and validate data entered
* Research correct coding practices, clearly document and share findings with others
* Recommend and suggest improvements to assigned projects
* Communicate with physicians and other team members either through discussion or in writing (e.g., formal queries) regarding missing, unclear, or conflicting health record documentation and policies to obtain clarification to provide accurate decisions
* Conduct follow-up re-evaluation of coding decisions to determine accuracy and make necessary revisions and adjustments to clarify decision rationales
* Act as a consultant to client and make recommendations based on experience performing audits
* Attend meetings with client when necessary to provide coding expertise when requested by Project Manager
* Attend kick-off meetings ...
....Read more...
Type: Permanent Location: Spokane, US-WA
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:24
-
Description & Requirements
Maximus is looking to hire a Senior Certified Coding Specialist to support our Office of Inspector General (OIG) program.
This is a fully remote position.
Why Maximus?
* Fully Remote Position
* Paid Time Off and Holidays
* Work/Life Balance
* Tuition Reimbursement
Work schedule will align to the Central Time Zone.
Essential Duties and Responsibilities:
- Provides advanced clinical inquiry responses (verbal and written) to health related inquiries from consumers, educators or medical/health professionals.
- Provides medical subject matter expertise.
- Performs advanced database searches.
- Composes documents, reports, and correspondence.
- Documents all incoming inquiries.
- May assist in training and leading subordinate specialists.
- Provides routine reports on the functions supported by the team.
Project-Specific Essential Job Duties:
* Audit inpatient, outpatient, and physician medical records to ensure compliance with the Medical Advantage Risk Adjustment standards including abstraction and assignment of appropriate ICD-9-CM and ICD-10-CM codes based on medical record documentation and clinical findings
* Expertise in the assignment of ICD-9-CM and ICD-10-CM codes and the correct application of the Official Guidelines for Coding and Reporting for each type of service (inpatient and outpatient)
* Apply knowledge of inpatient and outpatient ICD diagnosis code guidelines and clinical documentation requirements to assign HCCs
* Determine if code assignments submitted by Medicare Advantage Plans that result in Hierarchical condition categories (HCCs) are accurate thereby affecting the risk adjustment payment calculations made to Medicare Advantage Plans/Organizations
* Thorough knowledge of Risk Adjustment Diagnosis Validation (RADV) coding rules and requirements
* Ability to author clear and concise rationales that provide defensible support of decisions
* Collaborate with physicians and other coders to address issues were guidance and documentation are not clear
* Accurately enter abstracted data and codes into a system and validate data entered
* Research correct coding practices, clearly document and share findings with others
* Recommend and suggest improvements to assigned projects
* Communicate with physicians and other team members either through discussion or in writing (e.g., formal queries) regarding missing, unclear, or conflicting health record documentation and policies to obtain clarification to provide accurate decisions
* Conduct follow-up re-evaluation of coding decisions to determine accuracy and make necessary revisions and adjustments to clarify decision rationales
* Act as a consultant to client and make recommendations based on experience performing audits
* Attend meetings with client when necessary to provide coding expertise when requested by Project Manager
* Attend kick-off meetings ...
....Read more...
Type: Permanent Location: Memphis, US-TN
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:23
-
Description & Requirements
Maximus is looking to hire a Senior Certified Coding Specialist to support our Office of Inspector General (OIG) program.
This is a fully remote position.
Why Maximus?
* Fully Remote Position
* Paid Time Off and Holidays
* Work/Life Balance
* Tuition Reimbursement
Work schedule will align to the Central Time Zone.
Essential Duties and Responsibilities:
- Provides advanced clinical inquiry responses (verbal and written) to health related inquiries from consumers, educators or medical/health professionals.
- Provides medical subject matter expertise.
- Performs advanced database searches.
- Composes documents, reports, and correspondence.
- Documents all incoming inquiries.
- May assist in training and leading subordinate specialists.
- Provides routine reports on the functions supported by the team.
Project-Specific Essential Job Duties:
* Audit inpatient, outpatient, and physician medical records to ensure compliance with the Medical Advantage Risk Adjustment standards including abstraction and assignment of appropriate ICD-9-CM and ICD-10-CM codes based on medical record documentation and clinical findings
* Expertise in the assignment of ICD-9-CM and ICD-10-CM codes and the correct application of the Official Guidelines for Coding and Reporting for each type of service (inpatient and outpatient)
* Apply knowledge of inpatient and outpatient ICD diagnosis code guidelines and clinical documentation requirements to assign HCCs
* Determine if code assignments submitted by Medicare Advantage Plans that result in Hierarchical condition categories (HCCs) are accurate thereby affecting the risk adjustment payment calculations made to Medicare Advantage Plans/Organizations
* Thorough knowledge of Risk Adjustment Diagnosis Validation (RADV) coding rules and requirements
* Ability to author clear and concise rationales that provide defensible support of decisions
* Collaborate with physicians and other coders to address issues were guidance and documentation are not clear
* Accurately enter abstracted data and codes into a system and validate data entered
* Research correct coding practices, clearly document and share findings with others
* Recommend and suggest improvements to assigned projects
* Communicate with physicians and other team members either through discussion or in writing (e.g., formal queries) regarding missing, unclear, or conflicting health record documentation and policies to obtain clarification to provide accurate decisions
* Conduct follow-up re-evaluation of coding decisions to determine accuracy and make necessary revisions and adjustments to clarify decision rationales
* Act as a consultant to client and make recommendations based on experience performing audits
* Attend meetings with client when necessary to provide coding expertise when requested by Project Manager
* Attend kick-off meetings ...
....Read more...
Type: Permanent Location: Lubbock, US-TX
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:22
-
Description & Requirements
Maximus is looking to hire a Senior Certified Coding Specialist to support our Office of Inspector General (OIG) program.
This is a fully remote position.
Why Maximus?
* Fully Remote Position
* Paid Time Off and Holidays
* Work/Life Balance
* Tuition Reimbursement
Work schedule will align to the Central Time Zone.
Essential Duties and Responsibilities:
- Provides advanced clinical inquiry responses (verbal and written) to health related inquiries from consumers, educators or medical/health professionals.
- Provides medical subject matter expertise.
- Performs advanced database searches.
- Composes documents, reports, and correspondence.
- Documents all incoming inquiries.
- May assist in training and leading subordinate specialists.
- Provides routine reports on the functions supported by the team.
Project-Specific Essential Job Duties:
* Audit inpatient, outpatient, and physician medical records to ensure compliance with the Medical Advantage Risk Adjustment standards including abstraction and assignment of appropriate ICD-9-CM and ICD-10-CM codes based on medical record documentation and clinical findings
* Expertise in the assignment of ICD-9-CM and ICD-10-CM codes and the correct application of the Official Guidelines for Coding and Reporting for each type of service (inpatient and outpatient)
* Apply knowledge of inpatient and outpatient ICD diagnosis code guidelines and clinical documentation requirements to assign HCCs
* Determine if code assignments submitted by Medicare Advantage Plans that result in Hierarchical condition categories (HCCs) are accurate thereby affecting the risk adjustment payment calculations made to Medicare Advantage Plans/Organizations
* Thorough knowledge of Risk Adjustment Diagnosis Validation (RADV) coding rules and requirements
* Ability to author clear and concise rationales that provide defensible support of decisions
* Collaborate with physicians and other coders to address issues were guidance and documentation are not clear
* Accurately enter abstracted data and codes into a system and validate data entered
* Research correct coding practices, clearly document and share findings with others
* Recommend and suggest improvements to assigned projects
* Communicate with physicians and other team members either through discussion or in writing (e.g., formal queries) regarding missing, unclear, or conflicting health record documentation and policies to obtain clarification to provide accurate decisions
* Conduct follow-up re-evaluation of coding decisions to determine accuracy and make necessary revisions and adjustments to clarify decision rationales
* Act as a consultant to client and make recommendations based on experience performing audits
* Attend meetings with client when necessary to provide coding expertise when requested by Project Manager
* Attend kick-off meetings ...
....Read more...
Type: Permanent Location: San Antonio, US-TX
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:21
-
Description & Requirements
Maximus is looking to hire a Senior Certified Coding Specialist to support our Office of Inspector General (OIG) program.
This is a fully remote position.
Why Maximus?
* Fully Remote Position
* Paid Time Off and Holidays
* Work/Life Balance
* Tuition Reimbursement
Work schedule will align to the Central Time Zone.
Essential Duties and Responsibilities:
- Provides advanced clinical inquiry responses (verbal and written) to health related inquiries from consumers, educators or medical/health professionals.
- Provides medical subject matter expertise.
- Performs advanced database searches.
- Composes documents, reports, and correspondence.
- Documents all incoming inquiries.
- May assist in training and leading subordinate specialists.
- Provides routine reports on the functions supported by the team.
Project-Specific Essential Job Duties:
* Audit inpatient, outpatient, and physician medical records to ensure compliance with the Medical Advantage Risk Adjustment standards including abstraction and assignment of appropriate ICD-9-CM and ICD-10-CM codes based on medical record documentation and clinical findings
* Expertise in the assignment of ICD-9-CM and ICD-10-CM codes and the correct application of the Official Guidelines for Coding and Reporting for each type of service (inpatient and outpatient)
* Apply knowledge of inpatient and outpatient ICD diagnosis code guidelines and clinical documentation requirements to assign HCCs
* Determine if code assignments submitted by Medicare Advantage Plans that result in Hierarchical condition categories (HCCs) are accurate thereby affecting the risk adjustment payment calculations made to Medicare Advantage Plans/Organizations
* Thorough knowledge of Risk Adjustment Diagnosis Validation (RADV) coding rules and requirements
* Ability to author clear and concise rationales that provide defensible support of decisions
* Collaborate with physicians and other coders to address issues were guidance and documentation are not clear
* Accurately enter abstracted data and codes into a system and validate data entered
* Research correct coding practices, clearly document and share findings with others
* Recommend and suggest improvements to assigned projects
* Communicate with physicians and other team members either through discussion or in writing (e.g., formal queries) regarding missing, unclear, or conflicting health record documentation and policies to obtain clarification to provide accurate decisions
* Conduct follow-up re-evaluation of coding decisions to determine accuracy and make necessary revisions and adjustments to clarify decision rationales
* Act as a consultant to client and make recommendations based on experience performing audits
* Attend meetings with client when necessary to provide coding expertise when requested by Project Manager
* Attend kick-off meetings ...
....Read more...
Type: Permanent Location: Dallas, US-TX
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:19
-
Description & Requirements
Maximus is looking to hire a Senior Certified Coding Specialist to support our Office of Inspector General (OIG) program.
This is a fully remote position.
Why Maximus?
* Fully Remote Position
* Paid Time Off and Holidays
* Work/Life Balance
* Tuition Reimbursement
Work schedule will align to the Central Time Zone.
Essential Duties and Responsibilities:
- Provides advanced clinical inquiry responses (verbal and written) to health related inquiries from consumers, educators or medical/health professionals.
- Provides medical subject matter expertise.
- Performs advanced database searches.
- Composes documents, reports, and correspondence.
- Documents all incoming inquiries.
- May assist in training and leading subordinate specialists.
- Provides routine reports on the functions supported by the team.
Project-Specific Essential Job Duties:
* Audit inpatient, outpatient, and physician medical records to ensure compliance with the Medical Advantage Risk Adjustment standards including abstraction and assignment of appropriate ICD-9-CM and ICD-10-CM codes based on medical record documentation and clinical findings
* Expertise in the assignment of ICD-9-CM and ICD-10-CM codes and the correct application of the Official Guidelines for Coding and Reporting for each type of service (inpatient and outpatient)
* Apply knowledge of inpatient and outpatient ICD diagnosis code guidelines and clinical documentation requirements to assign HCCs
* Determine if code assignments submitted by Medicare Advantage Plans that result in Hierarchical condition categories (HCCs) are accurate thereby affecting the risk adjustment payment calculations made to Medicare Advantage Plans/Organizations
* Thorough knowledge of Risk Adjustment Diagnosis Validation (RADV) coding rules and requirements
* Ability to author clear and concise rationales that provide defensible support of decisions
* Collaborate with physicians and other coders to address issues were guidance and documentation are not clear
* Accurately enter abstracted data and codes into a system and validate data entered
* Research correct coding practices, clearly document and share findings with others
* Recommend and suggest improvements to assigned projects
* Communicate with physicians and other team members either through discussion or in writing (e.g., formal queries) regarding missing, unclear, or conflicting health record documentation and policies to obtain clarification to provide accurate decisions
* Conduct follow-up re-evaluation of coding decisions to determine accuracy and make necessary revisions and adjustments to clarify decision rationales
* Act as a consultant to client and make recommendations based on experience performing audits
* Attend meetings with client when necessary to provide coding expertise when requested by Project Manager
* Attend kick-off meetings ...
....Read more...
Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2024-03-22 09:07:18
