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Chart Review Specialist - CPC-A, C or P required - Growing Health Plan

Company: Fallon Community Health Plan
Location: Worcester
Posted on: February 14, 2019

Job Description:

Responsibilities: Perform retrospective chart reviews for designated populations & volumesOwn chart review process from start to endCollect documentation feedback and submit to Nurse Chart Review Coordinator and Chart Review Coordinator for provider education effortsUpdate risk adjustment software with all relevant chart review observationsMeet or exceed daily chart review targetsDevelop and present concise provider-specific feedback for targeted providers and provider groups.Identify diagnoses for submission as well as deletion in support of claims adjustment effortsEnsure chart reviews and related claims adjustment activities completed within regulatory data submission timelines and within CMS Coding and Coding Clinic guidelinesParticipate in corporate projects and subgroup meetings. Complete analyses related to corporate projects and business needs as needed.Participate in regional Coding Chapter meetings Qualifications: Education: High School diploma or GED required. Associated degree preferred. Certification: CPC-A, CPC-C or CPC-P is requiredExperience: Completion of 135 Internship/Externship hours in the health care industry.Medical billing/claims processing ,medical record auditing, medical record review, Medical record abstraction or combinationMedical terminologyICD-9 & ICD-10 compliantBasic MS Office skills; Excel and or AccessJT18 0

Keywords: Fallon Community Health Plan, Worcester , Chart Review Specialist - CPC-A, C or P required - Growing Health Plan, Healthcare , Worcester, Massachusetts

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