3 jobs found in Puerto Rico

Job Description Job Description ¡Transforma la calidad del cuidado en Puerto Rico como Codificador (CPC or CRC)! ???????? ¿Eres un profesional apasionado por la calidad, la innovación y el impacto en el mundo de la salud? En Provider Network Solutions, no solo diseñamos soluciones expertas e innovadoras para proveedores de servicios de salud y pagadores, sino que también transformamos vidas, asegurando atención de excelencia para los pacientes. ¿ Desde donde trabajarás? ???? Modalidad de trabajo presencial : Oficinas en San Juan, Puerto Rico. Tu futuro empieza aquí: En Provider Network Solutions, valoramos la comunicación, el aprendizaje constante y la innovación. A través de nuestro Provider Innovation Center, formamos líderes que redefinen el ecosistema de la salud. ¡Y queremos que tú seas parte de esta transformación! ¿Qué harás como Codificador? • Realizar auditorías internas de codificación para garantizar la...

Job Title Responsible for evaluating CHRA (Comprehensive Health Risk Assessment) forms received from Classicare policyholders and coding the documented clinical information according to the guidelines established by the unit. Essential Functions Performs coding of diagnoses documented in the CHRA (Comprehensive Health Risk Assessment) and registers the data into the appropriate application. Works on post-payment audits of adjudicated claims based on the information contained in the Comprehensive Health Risk Assessment comparing it to the information required, following the operational guidelines established by the unit. Generates referrals through the electronic app used in the Unit with providers and/or billing representatives, related to CHRA document management, to guide them and/or request correction of medical diagnoses due to incorrect coding, and inadequate, ambiguous, or incomplete medical documentation. Processes adjustments received for corrections in the CHRA,...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Medical Billing Specialist - Guaynabo, Puerto Rico Full Time GUAYNABO, PR, US The RCM Data Specialist will be responsible for working on the Avizzor portal, where they will audit and assign the billing of managed plans to the corresponding "Queques", as well as transmit cases in "Accepted" status. Responsibilities: Check that each invoice has the supporting documents required by Avizzor. If any document is missing, locate it in CPR+ and attach it to the invoice. Validate that the total charges for each invoice are the same in CPR+ and Avizzor. Notify your Supervisor in case of discrepancy. Check that the service date is the same as the "Delivery Ticket" and that the prescription date matches the indexed one. Verify that the authorization number (PA) reported in Avizzor matches the attached authorization. Send all invoices that...