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Below are links to job and career pages for various healthcare orgainzations in our area.
Mid-America Rheumatology Consultants, PA
The primary responsibility in this position is to handle patient billings and accounts. This is a full-time position.
Reporting Relationship: Reports to Office Manager
If interested, email resume to email@example.com
Job Description Summary :
As part of Blue KC’s Special Investigation Unit (SIU), the Clinical Investigator will review and investigate cases of potential fraud, waste and abuse (FWA). Conduct clinical reviews of medical documentation for appropriate coding and medical necessity. Research, review and analyze data to make clinical determinations. Make recommendations and Report findings and represent the SIU to both internal and external stakeholders. Document findings and recommendations in accordance with SIU policies and procedures.
1. Conducts pre-payment and post-payment clinical reviews of medical documentation to ensure appropriate coding, provide medical review interpretation and medical necessity. Drafts
medical records review summaries for each completed investigation. Support non-clinical SIU Fraud Investigators on cases through medical records review and clinical consulting.
2. Act as a clinical liaison between Medical Management, Medical Directors, Facets configuration teams, audit recovery vendor, and FWA vendor. Attend Medical Policy Review meetings to represent the SIU and recommend policy changes or edits and recommend new policies. Work with vendor based claim audit recovery program to research and develop new audit concepts to identify overpayment for recovery. Works with Clinical Reimbursement team to research, address and to implement new claims edits and/or edit existing edits.
3. Perform ongoing FWA risk assessments, leveraging data analytics to identify trends, patterns, outliers relative to peers and clinical standards, etc. In conjunction with the Manager and/or Senior Investigator, evaluate FWA risks and prioritize for further review, based upon member health/safety and protection of plan assets.
4. Monitor hotlines, internal referrals, external fraud alerts (e.g., CMS, BCBSA), external healthcare anti-fraud workgroups, and other resources potential FWA schemes.
5. Perform triage analysis on incoming leads and referrals to the SIU
6. Conduct investigations of FWA in accordance with SIU policies and procedures. May work with Manager and/or Senior Investigator on larger, more complex, investigations. Create and maintain detailed case files in accordance with SIU policies and procedures, where key investigative activities and outcomes are timely and accurately documented. Prepare detailed case reports summarizing investigative findings and recommendations. Present reports to key stakeholders (e.g., Provider Relations, Medical Management, Pharmacy, Claims, Legal).
7. Coordinate responses to subpoenas and preparation of cases for referral to law enforcement and/or regulators.
8. Perform day-to-day activities for vendor-based claim overpayment recovery program (e.g., data file exchanges, proposing / reviewing new audit concepts, coordinating claim adjustments, invoices).
9. Prepare reports for FWA Work Group meetings, executive updates, Blue KC Audit Committee, BCBSA/FEP surveys, and other reports as needed.
10. Assist manager in coordinating FWA training program for Blue KC employees and First Tier, Downstream and Related entities.
Apply at: https://bcbskc.wd1.myworkdayjobs.com/en-US/BCBS_External_Career_Site/job/Corporate-Office-Kansas-City-MO/Clinical-Investigator_R2911-1
This is a full time remote coding position.
JOB SUMMARY: The Coder Physician Group analyzes abstracts and codes the diagnostic and procedural information for physician outpatient and office medical records utilizing the International Classifications of Diseases, Tenth Revision (ICD-10-CM) and Current Procedural Terminology (CPT) in accordance with regulatory agencies and physician office specific guidelines. The Coder Physician Group enters the coded data and other abstracted data from the medical record into the electronic information system, facilitating the physician offices and the billing department’s indexing responsibility for internal use (such as to support medical care evaluation studies), and mandated reporting requirements. Holding a senior coding position, primary role in assisting medical staff members with improving quality of documentation. Participates in chart review projects as assigned.
EDUCATION, EXPERIENCE, TRAINING
1. Minimum one year experience with ICD-10 and CPT coding in an acute care setting; required.
2. Basic computer experience; required. Excel preferred.
3. Computer data entry with 10-key preferred, with accurate typing speed of 35 wpm; preferred.
4 Successful completion of college level courses in anatomy, physiology, medical terminology, and coding
5. ICD and CPT; CPC certification, required
6. ortho/ general surgery preferred
Please send resumes to Lori Call at firstname.lastname@example.org or apply online at St. Joseph Medical Center.
The Insurance Follow up/back coding position will be required to do the following.
Job Type: Full-time
Elvin Govada, MHA
Administrator | Head & Neck Surgery of Kansas City
Ph: 913-599-4800 | email@example.com
5370 College Blvd, Ste 100
Overland Park, KS 66211
Johnson County Specialty Practice has an opportunity for your career advancement. This private practice is searching for a great practice-based experienced CPC with leadership traits. If you have a business office background (Revenue Cycle experience) along with your coding certification, AND you have the talent and drive to progress into a leadership role, this could be a great career move.
Please send your resume to me, Syd Stevens, as I will be vetting for this position and will be able to provide more particulars for you. Nice start up salary. CPC-A’s with the experience mentioned very welcome to apply.
Interested candidates: firstname.lastname@example.org
Midwest Nephrology Consultants, P.A. has an temporary opening for an independent contractor (PRN) coder with significant experience with inpatient ICD-10 coding. Will be able to work from home and will need to be able to access hospital records with authorization. Compensation will be commensurate with level of experience and will be per chart. Production quotas NOT required. We need quality review and coding selections. Work as much as you want whenever it’s best for you.
Please send experience and resume to email@example.com. Will entertain resumes from CPC-A’s if you have the experience.
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AAPC of Kansas City
PO Box 12431
Kansas City, MO 64116
AAPC of KC offers scholarships to our members for local chapter events. See the scholarship application.
Do you need a Mentor, or would you like to become a Mentor? The AAPC of KC has a program to pair up members that need a little guidance and support with members who have a wealth of knowledge to share.
This program was developed to help our new and newly credentialed members with the support that is needed in our chosen career field.,Syd Stevens (firstname.lastname@example.org), Member Development Officer, can answer any questions you may have about this program.
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