FlexStaff Careers

Job Title Validates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record. Seeking RN candidates with a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Remote position in New York. Job Responsibility 1. Leverages clinical expertise to identify and validate DRG code assignment. 2. Full review of CDI suggested code changes. 3. Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization. 4. Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. 5. Applies coding rules and regulations to the validation review process. 6. Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. 7. Communicates DRG changes and rationale to the coding and CDI staff. 8....

Job Title Health Information Management Job Description Performs coding and abstracting duties to assure accurate completion of coding for all assigned patient records. Job Responsibility 1. Analyzes and interprets the medical record in its entirety to ensure accurate, complete and consistent selection of diagnoses and procedures to assure the production of quality healthcare data and accurate facility payment. 2. Applies understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable codes. 3. Utilizes resources and reference materials to identify appropriate codes and reference code applicability, rules and guidelines. 4. Applies the Uniform Hospital Discharge Data Set definitions as well as any additional regulatory guidelines and/or coding references to select the principal diagnosis, secondary diagnoses, all significant procedures, indicating the patient's acuity, severity of illness and risk of mortality (if applicable), as...

Job TitleValidates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record.Job ResponsibilitiesLeverages clinical expertise to identify and validate DRG code assignment.Full review of CDI suggested code changes.Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization.Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations.Applies coding rules and regulations to the validation review process.Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions.Communicates DRG changes and rationale to the coding and CDI staff.Identifies appropriate coding changes necessary to provide the most valid documentation in compliance with Federal and State regulations.Operates under general guidance and work assignments are varied and...

Revenue Cycle Quality And Performance ManagementResponds to commercial payers, managed care and third party review organizations in managing the appeals/denials process. Supports the review of denial trends and identifies coding issues and knowledge gaps.Job ResponsibilitiesSupports denial reviews and response processes; prioritizes and reviews cases denied by commercial payers.Reports program performance and/or corrective action to management on regular basis.Assists in monitoring inpatient denial types, volume and formulates responses to requesting agency; seeks additional resources (e.g. legal counsel) to resolve issues, as needed; develops case-specific written rationale to substantiate and communicate findings.Addresses coding issues and knowledge gaps; functions as a organization resource for litigation as related to coding denials.Maintains hospital database.Remains up-to-date on DRG system literature from all agencies.Maintains coding clinic up-dates.Operates under general...

We are looking for a seasoned Medical Insurance Biller with experience in collections, HMO and Managed Care billing to work for our external client, a healthcare management company that operates rehabilitation and nursing facilities across Long Island, NYC and Westchester. This role is located onsite in Baldwin, NY. Experience in Insurance & MLTC billing required. Responsibilities Verify patient eligibility and benefits via payer portals and phone. Manage billing and collections to ensure timely reimbursement. Perform A/R follow-up on unpaid, underpaid, or denied claims. Contact insurance carriers to request reprocessing and claim status updates. Identify, analyze, and resolve claim denials; prepare and submit insurance appeals. Review A/R and aging reports to prioritize accounts and determine next steps. Read and interpret EOBs/ERAs to confirm payments, adjustments, and patient responsibility. Prepare and submit corrected claims and supporting documentation as...

Job TitleValidates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record.Job ResponsibilitiesLeverages clinical expertise to identify and validate DRG code assignment.Full review of CDI suggested code changes.Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization.Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations.Applies coding rules and regulations to the validation review process.Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions.Communicates DRG changes and rationale to the coding and CDI staff.Identifies appropriate coding changes necessary to provide the most valid documentation in compliance with Federal and State regulations.Operates under general guidance and work assignments are varied and...

Job TitleValidates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record.Seeking RN candidates with a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Remote position in New York.Job Responsibility1. Leverages clinical expertise to identify and validate DRG code assignment.2. Full review of CDI suggested code changes.3. Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization.4. Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations.5. Applies coding rules and regulations to the validation review process.6. Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions.7. Communicates DRG changes and rationale to the coding and CDI staff.8. Identifies appropriate coding...

Job TitleConducting coding audits to optimize diagnosis related groupings. Developing and implementing coding instruction classes. Preparing coding guidelines; implementing coding changes.Job Responsibilities1. Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization.2. Demonstrates effective skills in validation; provides ad-hoc education to the coding staff.3. Able to communicate effectively with coders and CDI staff.4. Demonstrates knowledge of coding policy and procedures.5. Maintains knowledge of all current Federal and State coding guidelines; remains up-to-date on system literature from all agencies.6. Monitors and evaluates case mix index; demonstrates comprehensive knowledge of case mix indexing.7. Reviews potential reassignments; demonstrates accurate and timely review of all reassignments.8. Implements coding changes; demonstrates ability to relate coding changes accurately and efficiently to staff.9. Operates...

Job Title Validates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record. Job Responsibilities Leverages clinical expertise to identify and validate DRG code assignment. Full review of CDI suggested code changes. Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization. Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. Applies coding rules and regulations to the validation review process. Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. Communicates DRG changes and rationale to the coding and CDI staff. Identifies appropriate coding changes necessary to provide the most valid documentation in compliance with Federal and State regulations. Operates under general guidance...

Job Title Health Information Management Job Description Performs coding and abstracting duties to assure accurate completion of coding for all assigned patient records. Job Responsibility 1. Analyzes and interprets the medical record in its entirety to ensure accurate, complete and consistent selection of diagnoses and procedures to assure the production of quality healthcare data and accurate facility payment. 2. Applies understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable codes. 3. Utilizes resources and reference materials to identify appropriate codes and reference code applicability, rules and guidelines. 4. Applies the Uniform Hospital Discharge Data Set definitions as well as any additional regulatory guidelines and/or coding references to select the principal diagnosis, secondary diagnoses, all significant procedures, indicating the patient's acuity, severity of illness and risk of mortality (if...