Compliance Coding Nurse - LPN or RN
Location: Clayton Missouri
Description: Kforce is looking of Compliance Coding Nurse - LPN or RN right now, this occupation will be placed in Missouri. Further informations about this occupation opportunity kindly read the description below. A Kforce client is seeking a Compliance Coding Nurse in Clayton, Missouri (MO). This position will perform clinical medical claim review to ensure compliance with coding practices thro! ugh a comprehensive review and analysis of medical claims, medical records, claims history, state regulations, contractual obligations, corporate policies and procedures and guidelines established by the American Medical Association and the Centers for Medicare and Medicaid services .
Position Responsibilities:
- Analyze provider billing practices by utilizing code auditing software, provider documentation, administrative policies, regulatory codes, legislative directives, precedent, AMA and CMS code edit criterion
- Review medical records to ensure billing is consistent with medical record for appeals, adjustments and miscellaneous/unlisted code review
- Review cases with Medical Director to validate decisions and identify opportunities to create medical policy in the absence of guidelines
- Assist with research of health plan coding questions
- Identify potential billing errors, abuse, and fraud
- Identify oppo! rtunities to flag potential cases which may warrant a prepayme! nt review (versus an automatic system denial or payment)
- Maintain appropriate records, files, documentation, etc
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If you were eligible to this occupation, please email us your resume, with salary requirements and a resume to Kforce.
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This occupation starts available on: Fri, 14 Jun 2013 21:39:36 GMT