7 jobs found in Grants Pass

Coding AuditorAllCare Health | Quality Department | Grants Pass, OregonSummary of the PositionThe Coding Auditor is responsible for developing, implementing, and maintaining auditing practices related to medical record coding and documentation to support accurate and complete risk adjustment outcomes for Medicare members.This position reviews medical records and coding for accuracy and compliance with Centers for Medicare & Medicaid Services (CMS) Risk Adjustment Data Validation (RADV) requirements, identifies coding and documentation trends, and works collaboratively with providers and internal teams to improve documentation, coding accuracy, and risk adjustment outcomes.Essential DutiesEnsures the accuracy and correlation of diagnosis codes, dates of service, medical record documentation, and other information used to support risk adjustment.Identifies, analyzes, and communicates trends related to coding accuracy and documentation quality.Develops and supports intervention...

Options for Southern Oregon in Grants Pass, OR, is seeking a Medical Billing Specialist to support our billing team with patient payments and insurance claims in behavioral health services. You will enter data into the EHR, manage claims, and work with insurance providers to resolve denials, ensuring timely, accurate reimbursements while maintaining confidentiality and meeting deadlines. Strong organizational skills and knowledge of Oregon billing requirements are essential, with prior #J-18808-Ljbffr

Medical Billing Specialist Benefits include: Family medical, dental, long-term disability, 403(b) plan with 6% match, and more. Generous paid time off policy. (Annual accrual up to 208 hours - based on FTE status and available to use upon accrual). Plus, 11 paid holidays annually. Hours: Monday-Friday 8am-5pm Overview The Medical Billing Specialist assists the billing department to accurately manage patient payments and insurance claims. The specialist submits claims and/or encounters for clinical services to insurance companies, and other payers, to ensure proper reimbursement. Adheres to claim submission deadlines, posts payments and enters data into the electronic health record (EHR). Utilizes medical terminology, CPT coding, ICD coding, and HCPCS in relation to behavioral health services to process claims through the EHR. Performs quality assurance reviews to ensure clean claims are submitted. Maintains working knowledge of the State of Oregon's...

Coding Auditor AllCare Health | Quality Department | Grants Pass, Oregon We Are Seeking Qualified Candidates to Join Our Team! AllCare Health offers competitive wages and an excellent benefits package, including affordable healthcare, 401(k) retirement, wellness programs, and flexible scheduling options. Summary of the Position The Coding Auditor is responsible for developing, implementing, and maintaining auditing practices related to medical record coding and documentation to support accurate and complete risk adjustment outcomes for Medicare members. This position reviews medical records and coding for accuracy and compliance with Centers for Medicare & Medicaid Services (CMS) Risk Adjustment Data Validation (RADV) requirements, identifies coding and documentation trends, and works collaboratively with providers and internal teams to improve documentation, coding accuracy, and risk adjustment outcomes. Essential Duties Ensures the accuracy and...

Certified Claims Call Center Processor I at AllCare Health with the Claims department in Grants Pass, Oregon We Are Seeking Qualified Candidates to Join Our Team! AllCare Health offers competitive wages, an excellent benefits package including affordable healthcare, 401k retirement, wellness programs, and flexible schedule options. Summary of the Position The Certified Claims Call Center Processor I serves as a primary point of contact for provider offices and their authorized representatives, responding to inbound calls and electronic inquiries regarding professional and facility claims processing and adjudication. This role combines customer service and certified claims processing responsibilities by independently resolving provider inquiries, researching claim issues, and adjudicating professional claims in accordance with company policy, contract language, coding guidelines, and applicable regulatory requirements....

Claims Processing Supervisor AllCare Health | Claims Department We Are Seeking Qualified Candidates to Join Our Team! AllCare Health offers competitive wages and an excellent benefits package, including affordable healthcare, 401(k) retirement, wellness programs, and flexible scheduling options. Summary of the Position The Claims Processing Supervisor ensures that internal and external departmental performance requirements are consistently met. This role oversees the day-to-day activities of the Claims Processing team, assigns work and coordinates efficient workflows to meet contractual and operational requirements, and serves as a hands-on resource for staff regarding training, questions, and claims processing best practices. Essential Duties Provides one-on-one support and initial training for new hires and facilitates monthly mandatory training sessions for Claims Processing staff. Establishes and maintains a professional, supportive, and provider...

Coding Auditor AllCare Health | Quality Department | Grants Pass, Oregon We Are Seeking Qualified Candidates to Join Our Team! AllCare Health offers competitive wages and an excellent benefits package, including affordable healthcare, 401(k) retirement, wellness programs, and flexible scheduling options. Summary of the Position The Coding Auditor is responsible for developing, implementing, and maintaining auditing practices related to medical record coding and documentation to support accurate and complete risk adjustment outcomes for Medicare members. This position reviews medical records and coding for accuracy and compliance with Centers for Medicare & Medicaid Services (CMS) Risk Adjustment Data Validation (RADV) requirements, identifies coding and documentation trends, and works collaboratively with providers and internal teams to improve documentation, coding accuracy, and risk adjustment outcomes. Essential Duties Ensures the accuracy and...