MaineHealth

Description MaineHealth Corporate Professional - Nonclinical Req #: 16331 Fully Remote Schedule The Inpatient Coder III role is responsible for identifying and accurately assigning ICD diagnostic and ICD procedural codes after thorough review of provider documentation; and abstracts demographic and clinical information for inpatient records for the purpose of data collection, reimbursement, research and compliance with state and federal regulations and other agencies utilizing established coding principles and protocols. Required Minimum Knowledge, Skills, and Abilities (KSAs) Education: Associate's Degree in Health Information Management and/or Bachelor's Degree in Health Information Management, or other science-based degree such as nursing preferred. License/Certifications: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Registered Nurse (RN), Certified Inpatient Coder (CIC), Certified Coding...

Description Fully Remote working position The Medical Auditor role reviews medical necessity and Correct Coding Initiative claim edits. Assesses clinical documentation for supporting medical necessity to appeal denials or audits. Required Minimum Knowledge, Skills, and Abilities (KSAs) Education: Bachelor's Degree in Healthcare and/or related field required. License/Certifications: CPC, COC or other coding certification preferred. Current licensure as a Registered Nurse preferred. Experience: Three years of coding and/or clinical experience required. Additional Skills/Requirements Required: N/A Additional Skills/Requirements Preferred: Current knowledge of CPT, HCPCS, Revenue and ICD codes. Current knowledge of the rules and regulations as they relate to State and Federal Government and 3rd Party Payers. In-depth understanding of Medicare's LCD and NDC medical necessity guidelines, appeals process and timelines. Additional Information With a career...