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Job Requirements of Medical Chart Review Specialist:
-
Employment Type:
Contractor
-
Location:
Salinas, CA (Onsite)
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Medical Chart Review Specialist
Careers Integrated Resources Inc
Salinas, CA (Onsite)
Contractor
Job Title: Medical Chart Review Specialist
Location: Salinas, CA 93901
Duration: 3 Months+ (Possibility of extension)
Shift: Mon - Fri 40hr/ Weekly
Pay rate: $40/hr. on W2
Duties:
Skills:
Education:
Location: Salinas, CA 93901
Duration: 3 Months+ (Possibility of extension)
Shift: Mon - Fri 40hr/ Weekly
Pay rate: $40/hr. on W2
Duties:
- Under supervision of the Director of Diagnostic Imaging, obtains authorizations for procedures, performs audits for Radiology billing and checks insurance eligibility per protocol.
- Performs any combination of the following duties as assigned by the director. Works closely with the Special Procedures Analyst and works collaboratively with Health
- Information Management, Business Services, Radiologists, Auditing and Compliance to ensure billing, authorizations and insurance eligibility are performed per protocol/policy/regulations. Ensures that job tasks are done correctly and in a timely manner.
- Ensures that staff is kept informed on eligibility, authorizations and billing issues as needed.
- This is specific to the cardiac cath lab and cardiology service line, including electrophysiology, Interventional radiology, and structural heart interventional procedures, in addition to the non-invasive imaging changes.
Skills:
- Actively participates in auditing Imaging Services through medical chart audits, correlating medical documentation and patient charges.
- Maintains working knowledge of current billing methods, policies, and procedures in Imaging Department cost centers.
- Consults with Department Management and available resources to gather information relevant to work practices and functions.
- Seeks guidance and direction in problem solving when appropriate and assists in resolving problems.
- Identifies and reports to department supervisor areas of concern identified during work activities.
- Promotes interdepartmental communications by participation in committee or group activities as appropriate or requested.
- Remains abreast of current procedures through attendance at in-services and interaction with peers.
- Participates in and provides clerical support for performance improvement activities; compiles statistical reports.
- Maintains confidentiality of medical record and all related information.
- Supports and upholds Hospital policies, procedures, Rules and Regulations, TJC, State and Federal requirements.
- Maintains a pleasant, courteous personality with the ability to act as a public relations agent between the Hospital and outside agencies.
- Ensures that persons who work for, are served by, or are associated with the Hospital, receive the highest degree of attention and courtesy possible by personally complying with the hospital’s STAR values.
- Utilizes Hospital Information System in audit and departmental processes.
- Coordinates with Internal Audit and Compliance Department Clinical Review Specialist for performing chart review and billing related activities.
- Runs eligibility through module in HIS or other insurance website and follows up on any items that do not meet eligibility to ensure patients are aware of insurance status prior to appointment.
- Obtains insurance authorization for procedures as requested.
- Obtains education in order to stay current on billing changes.
- Performs other related duties as required
Education:
- High school diploma or GED required
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