<p>We are looking for an Inpatient Coding Specialist to join our team in Sacramento, California. This contract position involves reviewing and analyzing medical records to accurately assign diagnostic and procedural codes based on established guidelines and regulations. The role requires a thorough understanding of inpatient coding principles to ensure compliance with federal and state requirements while supporting efficient revenue cycle processes.</p><p><br></p><p>Responsibilities:</p><p>• Accurately assign ICD-10-CM and ICD-10-PCS codes to inpatient records based on medical documentation.</p><p>• Ensure proper grouping into Medicare Severity Diagnosis Related Groups (DRG) or All Patient Refined Diagnosis Related Groups (APR-DRG) for optimal reimbursement.</p><p>• Abstract required data elements from medical records in alignment with facility-specific guidelines.</p><p>• Monitor discharged but not billed accounts to facilitate timely and compliant revenue cycle processing.</p><p>• Collaborate with clinical documentation specialists and medical staff to validate and enhance documentation.</p><p>• Maintain high standards of coding accuracy and productivity while adhering to quality benchmarks.</p><p>• Utilize software tools such as Epic, 3M Encoder, and other coding systems to validate and compile medical information.</p><p>• Analyze and ensure compliance with coding, billing, and data collection regulations.</p><p>• Address missing or unclear information by seeking clarification and ensuring proper documentation.</p><p>• Independently manage workload and prioritize tasks to meet departmental productivity standards.</p>
We are looking for a skilled Medical Collections Specialist to join our team in Sacramento, California. This Contract to potential permanent position offers the opportunity to work in an engaging and fast-paced environment where attention to detail and strong communication skills are essential. The role focuses on managing medical claims, resolving discrepancies, and ensuring timely reimbursements, with the possibility of long-term placement based on performance.<br><br>Responsibilities:<br>• Review and interpret contracts to identify allowed amounts and ensure proper claim adjudication.<br>• Analyze Explanation of Benefits (EOBs) to verify payment accuracy and patient liability.<br>• Communicate effectively with insurance companies to dispute denied or underpaid claims, ensuring resolution.<br>• Provide clear explanations to patients regarding their balances, claim outcomes, and financial responsibilities.<br>• Draft compelling appeals to challenge claim denials and secure appropriate reimbursements.<br>• Maintain a thorough understanding of various insurance products, including Medicare Advantage plans.<br>• Manage high-volume workloads efficiently while maintaining accuracy and meeting production goals.<br>• Collaborate with team members to handle complex claims and develop effective solutions.<br>• Utilize analytical skills to make informed decisions on resolving claims and account discrepancies.<br>• Ensure consistent and timely follow-up on accounts to achieve and exceed recovery targets.
We are looking for a Medical Payment Poster Specialist to join our team in Sacramento, California. This is an in-office, Contract position with the potential to become permanent, where you will play a crucial role in ensuring accurate and efficient posting of payments to patient accounts. If you have experience in medical billing and payment processing, we encourage you to apply.<br><br>Responsibilities:<br>• Accurately post insurance payments to individual patient accounts, ensuring compliance with contracts and organizational policies.<br>• Verify payment amounts to ensure correctness and adherence to agreements.<br>• Record patient payments in the designated system with precision.<br>• Process denials and zero payments, flagging accounts for follow-up by medical collectors.<br>• Apply takebacks and recoups following established procedures.<br>• Communicate payment trends, including discrepancies, short payments, and denials, to leadership for resolution.<br>• Reconcile daily payment postings against settlement reports to maintain balanced accounts.<br>• Route payer correspondence to appropriate team members for timely follow-up.<br>• Utilize a thorough understanding of contracts and policies to ensure accurate application during payment posting.