DUTIES AND RESPONSIBILITIES Charge capture and over-the-counter payment posting. Insurance verification and eligibility. Insurance pre-authorization/pre-certifications. Counseling patients and families on insurance and payment issues prior to surgery. Ensures all insurance, demographic, and eligibility information is obtained
By joining Sedgwick, youll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with
Remote MSDRG Auditor The DRG Validation Auditor is a member of the CGI Healthcare Compliance, DRG Validation Team, with responsibility for reviewing medical records to determine the accuracy of coding and reimbursement for clinical services rendered to
Revenue Specialist, Denials EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM intelligent automation platform to improve financial sustainability for hospitals, health systems,
DRG Validator/Reviewer The DRG Validator/Reviewer is responsible for reviewing post-billed inpatient claims to identify and validate missed reimbursement opportunities based on diagnosis and procedure coding. Working within a specialized DRG (Diagnosis-Related Group) database, DRG Reviewers utilize their
Essential Duties and Responsibilities: - Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data. - Enter coded data into a system
MEDHOST, a division of Harris; is seeking an Account Follow-up Representative I who is responsible for reviewing and resolving outstanding insurance balances for hospital patient accounts. The Account Follow-up Representative I is required to learn multiple