Assess the clinical indicators and suggestions of various query requests received from the MD Reviewer/ DRG Integrity Specialist Collaborate and communicate as necessary to clarify and avoid misinterpretation to ensure the query is optimally written and distributed to the correct client provider Creates queries in a compliant manner in accordance with AHIMA and ACDIS comp

Schedules all follow up appointments in the practice management system following the provider order and/or office protocol in a high volume clinic setting. Cancels/reschedules appointments according to patient or physician scheduling changes; notifies appropriate clinic personnel. Arranges for patients to have financial counseling as needed. Demonstrates an understanding

Relying on clinical background, reviews health claims providing medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with Concentra Physician Review policies, procedures, and performance standards and URAAC guidelines and state regulations. Responsibilities MAJOR DUTIES AND RESPONSIBILITIES Rev

Relying on clinical background, reviews health claims providing medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with Concentra Physician Review policies, procedures, and performance standards and URAAC guidelines and state regulations. Responsibilities MAJOR DUTIES AND RESPONSIBILITIES Rev

Under indirect supervision performs a variety of basic to complex processing tasks related to ensuring timely and accurate billing and reconciliation of discrepancies in accordance with Concentra Medical Compliance Administration practices, policies and procedures. Works closely with the Central Billing Office to report monthly financials. Responsibilities Process monthly

Assigns appropriately sequenced and compliant ICD 10 CM/PCS codes as documented in the electronic medical record (EMR). Applies definition of principal diagnosis for proper assignment of MS DRGs, APR DRGs, and POA indicators using a designated encoder/grouper, while ensuring compliance with nationally established coding guidelines. Utilizes selected encoder and/or compute

Schedules all follow up appointments in the practice management system following the provider order and/or office protocol in a high volume clinic setting. Cancels/reschedules appointments according to patient or physician scheduling changes; notifies appropriate clinic personnel. Arranges for patients to have financial counseling as needed. Demonstrates an understanding

Include Ensure patient demographic information is accurate and complete Utilize customer hospital systems or approved vendors to research and obtain/verify patient demographic information Validate signature documents such as AOB (Assignment of Benefits), consents, CMN (Certificate of Medical Necessity) Verify patient name is consistent on all documents Verify date of servi