3 jobs found in Montpelier

**Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** This job is responsible for educating providers on proper billing behavior and proper usage of procedure codes and/or modifiers who are identified as outliers in regards to billing Highmark for certain targeted codes; outreach may occur in various formats including written letters, emails, and consultations via telephone. Documents explanations from Provider Outliers to be used in the analysis of billing behavior and cost savings. **ESSENTIAL RESPONSIBILITIES** + Performs outreach via telephone or other means to identified Outlier Providers informing them of their inclusion as an Outlier; meaningfully discusses the Outlier Providers' billing practices and provides education on proper usage of procedure codes and/or modifiers. May also field incoming calls from providers. + Applies medical coding knowledge to determine applicable education for Outlier Providers on industry standards and guidelines as...

**Job Family** **:** General Coding **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** **The General Surgery Coder** must be proficient in surgical coding for all Trauma Surgery type cases. E/M experience is also required for associated providers. The coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding managerthe coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The coder scope may involve...

**Job Family** **:** General Coding **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** The Remote Medical Coder Hospital Inpatient will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 and PCS Diagnosis codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding managerthe coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS and any other official coding guidelines established for use with mandated standard code sets. This is a 100% full time remote position. + Maintains a working knowledge of ICD-9-10 PCS and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and...