40 Cms Guidelines Jobs

Job Family Coding OP (India) Travel Required None Clearance Required None What Will You Do Analyzing patient information and accurately converting it into medical codes. Ensuring coding accuracy to avoid billing denials. Validating documentation to support Facility Surgical codes based on medical decision-making or time. Maintaining current coding knowledge and credentials is also part of the role Extensive knowledge of ICD-10-CM, CPT, and HCPCS Level II coding principles and guidelines. Familiarity with reimbursement systems, federal, state, and payor-specific regulations and policies related to coding and billing. What You Will Need Minimum requirement of 1+ years experience in a relevant ...

Role Overview: As an Analyst in Clinical Research, you will play a crucial role in developing two main artifacts: Human Readable and Data Dictionary using MAT tool. Your responsibilities will also include analyzing measure specifications to translate data into clinical form while closely collaborating with clinical teams, database management personnel, and project managers. Key Responsibilities: - Registry Data Management: - Create and maintain two main artifacts: Human Readable and Data Dictionary. - Ensure the artifacts are updated for every performance year. - Analyze CMS published documents for any updates. - Submit required registry reports accurately and in a timely manner. - Data Anal...

Role Overview: As an integral part of the team, you will be responsible for conducting audits of patient medical records to verify coding accuracy and documentation compliance. You will meticulously review both inpatient and outpatient records to ensure that services are correctly documented and billed. Your keen attention to detail will be crucial in ensuring compliance with healthcare regulations such as HIPAA, Medicare/Medicaid, and CMS guidelines. Key Responsibilities: - Identify errors in coding, billing, and documentation - Provide valuable feedback to relevant departments - Prepare comprehensive audit reports outlining findings, trends, and recommendations - Collaborate with coding, b...

As a Data Management candidate with experience in Revenue Cycle Management (RCM) and US Healthcare, your role will be critical in ensuring accurate reporting, optimizing revenue processes, and maintaining high-quality data integrity across systems. Key Responsibilities: - Maintain and update large data sets related to billing and financial operations to ensure data accuracy and compliance with company policies and healthcare regulations. - Create and maintain advanced Excel reports, dashboards, and models for monitoring billing performance, trends, KPIs, and revenue leakage. - Analyze data to identify patterns, anomalies, or opportunities for process improvement within the RCM lifecycle. - R...

As a Coding OP in India, your role will involve analyzing patient information and accurately converting it into medical codes. You will be responsible for ensuring coding accuracy to avoid billing denials and validating documentation to support E/M (Evaluation and Management) codes based on medical decision-making or time. It is crucial to maintain current coding knowledge and credentials, with extensive knowledge of ICD-10-CM, CPT, and HCPCS Level II coding principles and guidelines. Key Responsibilities: - Analyzing patient information and converting it into medical codes - Ensuring coding accuracy to prevent billing denials - Validating documentation to support E/M codes - Maintaining cur...

Role Overview: As a Multispecialty Surgery Coding SME (Professional & Facility), you will be responsible for serving as a Subject Matter Expert (SME) in both professional and facility surgery coding. Your role will involve providing extensive knowledge, training, auditing, and guidance on complex surgical coding across various specialties, ensuring adherence to ICD-10-CM, CPT, HCPCS, and CMS guidelines. Key Responsibilities: - Act as the primary resource for addressing inquiries related to multispecialty surgical coding for both professional and facility settings. - Accurately assign codes for intricate surgical procedures in specialties such as orthopedic, cardiovascular, neurological, dige...

As a Certified Coding Specialist (CCS) and Certified Inpatient Coder (CIC), your role will involve the following key responsibilities: Role Overview: You will be responsible for conducting detailed DRG validation audits on selected inpatient medical records to ensure coding accuracy, completeness, and compliance with ICD-10-CM/PCS, AHA Coding Clinic, and CMS guidelines. Your role will involve reviewing documentation to confirm that all reported diagnoses and procedures are supported and coded to the highest level of specificity. You will also validate the assignment of the discharge disposition, Present on Admission (POA) indicators, and sequencing of diagnoses. Identifying and correcting di...

As a Data Scientist specializing in Healthcare Claims Analytics, your role will involve the following key responsibilities: - Analyze medical, pharmacy, and hospital claims data including CPT, HCPCS, ICD-10, DRG, NPI, etc. - Identify patterns of fraud, waste, and abuse (FWA) within claims data. - Develop predictive models for risk stratification, readmission prediction, and cost forecasting. - Engage in value-based care models, risk adjustment, and population health analytics. In addition, you will be responsible for Data Engineering & Management tasks such as: - Working with large-scale healthcare databases. - Utilizing SQL, Python, R, PySpark, and cloud-based big data solutions like AWS, A...

Job Family Coding OP (India) Travel Required None Clearance Required None What Will You Do Analyzing patient information and accurately converting it into medical codes. Ensuring coding accuracy to avoid billing denials. Validating documentation to support ED, E/M (Evaluation and Management) codes based on medical decision-making or time. Maintaining current coding knowledge and credentials is also part of the role Extensive knowledge of ICD-10-CM, CPT, and HCPCS Level II coding principles and guidelines. Familiarity with reimbursement systems, federal, state, and payor-specific regulations and policies related to coding and billing. What You Will Need Minimum requirement of 1+ years experie...

Role Overview: As a Coding OP in India, your main responsibility will be to analyze patient information and accurately convert it into medical codes. You will need to ensure coding accuracy to avoid billing denials and validate documentation to support ED, E/M (Evaluation and Management) codes based on medical decision-making or time. It is crucial to maintain current coding knowledge and credentials, including extensive knowledge of ICD-10-CM, CPT, and HCPCS Level II coding principles and guidelines. Key Responsibilities: - Analyze patient information and accurately convert it into medical codes - Ensure coding accuracy to avoid billing denials - Validate documentation to support ED, E/M co...

Job Family Coding OP (India) Travel Required None Clearance Required None Job Posting What Will You Do Analyzing patient information and accurately converting it into medical codes. Ensuring coding accuracy to avoid billing denials. Validating documentation to support ED, E/M (Evaluation and Management) codes based on medical decision-making or time. Maintaining current coding knowledge and credentials is also part of the role Extensive knowledge of ICD-10-CM, CPT, and HCPCS Level II coding principles and guidelines. Familiarity with reimbursement systems, federal, state, and payor-specific regulations and policies related to coding and billing. What You Will Need Minimum requirement of 1+ y...

Certification- Mandatory CCS - Certified Coding Specialist, CIC - Certified Inpatient Coder Coding Audit and Review Conduct detailed DRG validation audits on selected inpatient medical records to ensure coding accuracy, completeness, and compliance with ICD-10-CM/PCS, AHA Coding Clinic, and CMS guidelines. Review documentation to confirm that all reported diagnoses and procedures are supported and coded to the highest level of specificity. Validate the assignment of the discharge disposition, Present on Admission (POA) indicators, and sequencing of diagnoses. Identify and correct discrepancies between coded data and clinical documentation. Perform secondary reviews as needed for complex or d...

Job Family Coding OP (India) Travel Required None Clearance Required None What Will You Do Analyzing patient information and accurately converting it into medical codes. Ensuring coding accuracy to avoid billing denials. Validating documentation to support E/M codes based on medical decision-making or time. Maintaining current coding knowledge and credentials is also part of the role Extensive knowledge of ICD-10-CM, CPT, and HCPCS Level II coding principles and guidelines. Familiarity with reimbursement systems, federal, state, and payor-specific regulations and policies related to coding and billing. What You Will Need Minimum requirement of 1 years experience in a relevant coding specialt...

Job Family Coding OP (India) Travel Required None Clearance Required None What Will You Do Analyzing patient information and accurately converting it into medical codes. Ensuring coding accuracy to avoid billing denials. Validating documentation to support Anesthesia with Surgery codes based on medical decision-making or time. Maintaining current coding knowledge and credentials is also part of the role Extensive knowledge of ICD-10-CM, CPT, and HCPCS Level II coding principles and guidelines. Familiarity with reimbursement systems, federal, state, and payor-specific regulations and policies related to coding and billing. What You Will Need Minimum requirement of 2 years experience in a rele...

Job Family Coding OP (India) Travel Required None Clearance Required None What Will You Do Analyzing patient information and accurately converting it into medical codes. Ensuring coding accuracy to avoid billing denials. Validating documentation to support E/M (Evaluation and Management) codes based on medical decision-making or time. Maintaining current coding knowledge and credentials is also part of the role Extensive knowledge of ICD-10-CM, CPT, and HCPCS Level II coding principles and guidelines. Familiarity with reimbursement systems, federal, state, and payor-specific regulations and policies related to coding and billing. What You Will Need Minimum requirement of 2 years experience i...

Job Family Coding OP (India) Travel Required None Clearance Required None What Will You Do Analyzing patient information and accurately converting it into medical codes. Ensuring coding accuracy to avoid billing denials. Validating documentation to support E/M codes based on medical decision-making or time. Maintaining current coding knowledge and credentials is also part of the role Extensive knowledge of ICD-10-CM, CPT, and HCPCS Level II coding principles and guidelines. Familiarity with reimbursement systems, federal, state, and payor-specific regulations and policies related to coding and billing. What You Will Need Minimum requirement of 1 years experience in a relevant coding specialt...

Job Family Coding OP (India) Travel Required None Clearance Required None What Will You Do Analyzing patient information and accurately converting it into medical codes. Ensuring coding accuracy to avoid billing denials. Validating documentation to support E/M codes based on medical decision-making or time. Maintaining current coding knowledge and credentials is also part of the role Extensive knowledge of ICD-10-CM, CPT, and HCPCS Level II coding principles and guidelines. Familiarity with reimbursement systems, federal, state, and payor-specific regulations and policies related to coding and billing. What You Will Need Minimum requirement of 1 years experience in a relevant coding specialt...

Job Family Coding OP (India) Travel Required None Clearance Required None Job Posting What Will You Do Analyzing patient information and accurately converting it into medical codes. Ensuring coding accuracy to avoid billing denials. Validating documentation to support ED E/M (Evaluation and Management) codes based on medical decision-making or time. Maintaining current coding knowledge and credentials is also part of the role Extensive knowledge of ICD-10-CM, CPT, and HCPCS Level II coding principles and guidelines. Familiarity with reimbursement systems, federal, state, and payor-specific regulations and policies related to coding and billing. What You Will Need Minimum requirement of 1+ ye...

Role: Emergency Department CDI (ED CDI) Specialist Department: CDI Qualification : life science stream At least 2 yrs in clinical documentation improvement • Certifications: CPC Location: Chennai/ Hyderabad Contact : 6379093874 Sangeetha(Whats App)

Job Family Coding OP (India) Travel Required None Clearance Required None What Will You Do Analyzing patient information and accurately converting it into medical codes. Ensuring coding accuracy to avoid billing denials. Validating documentation to support Ancillary codes based on medical decision-making or time. Maintaining current coding knowledge and credentials is also part of the role Extensive knowledge of ICD-10-CM, CPT, and HCPCS Level II coding principles and guidelines. Familiarity with reimbursement systems, federal, state, and payor-specific regulations and policies related to coding and billing. What You Will Need Minimum requirement of 1+ years experience in a relevant coding s...

Job Family Coding OP (India) Travel Required None Clearance Required None What Will You Do Analyzing patient information and accurately converting it into medical codes. Ensuring coding accuracy to avoid billing denials. Validating documentation to support E/M (Evaluation and Management) codes based on medical decision-making or time. Maintaining current coding knowledge and credentials is also part of the role Extensive knowledge of ICD-10-CM, CPT, and HCPCS Level II coding principles and guidelines. Familiarity with reimbursement systems, federal, state, and payor-specific regulations and policies related to coding and billing. What You Will Need Minimum requirement of 1+ years experience ...

Job Family Coding OP (India) Travel Required None Clearance Required None What Will You Do Analyzing patient information and accurately converting it into medical codes. Ensuring coding accuracy to avoid billing denials. Validating documentation to support E/M (Evaluation and Management) codes based on medical decision-making or time. Maintaining current coding knowledge and credentials is also part of the role Extensive knowledge of ICD-10-CM, CPT, and HCPCS Level II coding principles and guidelines. Familiarity with reimbursement systems, federal, state, and payor-specific regulations and policies related to coding and billing. What You Will Need Minimum requirement of 2 years experience i...

Job Family Coding OP (India) Travel Required None Clearance Required None What Will You Do Analyzing patient information and accurately converting it into medical codes. Ensuring coding accuracy to avoid billing denials. Validating documentation to support E/M (Evaluation and Management) codes based on medical decision-making or time. Maintaining current coding knowledge and credentials is also part of the role Extensive knowledge of ICD-10-CM, CPT, and HCPCS Level II coding principles and guidelines. Familiarity with reimbursement systems, federal, state, and payor-specific regulations and policies related to coding and billing. What You Will Need Minimum requirement of 1+ years experience ...

Job Family Coding OP (India) Travel Required None Clearance Required None What Will You Do Analyzing patient information and accurately converting it into medical codes. Ensuring coding accuracy to avoid billing denials. Validating documentation to support E/M (Evaluation and Management) codes based on medical decision-making or time. Maintaining current coding knowledge and credentials is also part of the role Extensive knowledge of ICD-10-CM, CPT, and HCPCS Level II coding principles and guidelines. Familiarity with reimbursement systems, federal, state, and payor-specific regulations and policies related to coding and billing. What You Will Need Minimum requirement of 1+ years experience ...

As a detail-oriented and analytical Data Management candidate with experience in RCM and US Healthcare, you will play a crucial role in supporting financial and operational processes. Your strong background in healthcare revenue cycle management (RCM) and advanced data analysis skills using Excel will be essential in ensuring accurate reporting, optimizing revenue processes, and maintaining high-quality data integrity across systems. Key Responsibilities: - Maintain and update large data sets related to billing and financial operations to ensure data accuracy and compliance with company policies and healthcare regulations. - Create and maintain advanced Excel reports, dashboards, and models ...