 |
     
 |
 | |
Search HIPusa.com Powered by 
|
Return to Listing
Medical Rates Specialist
|
| BTS |
| |
| Location: 441 9th Avenue |
| MRS BTS |
| |
| Essential Duties: |
- Compiles, develops, and maintains documentation supporting the creation of nomenclature and allowances for all levels of GHI coverage.
- Initiates additions, changes or deletion of records contained in files utilized by the system to process or pay claims.
- Completes manual rate loads for all fee schedules, based on rate assignments and annual updates.
- Analyzes data contained in all associated claims processing files for validity recommending and/or initiating corrections or modifications.
- Analyzes relativity of similar CPT and HCPCS codes, for the purpose of establishing updated prevailing fee schedules.
- Responds to internal email and telephone inquiries arising from rates and its development.
- Creating fee schedules or fee schedule replacement pages corresponding to additions, changes or deletion or procedures and/or nomenclature, creating/editing documentation required by Rates and Benefits such as special reports, letters, mailing lists and spreadsheets.
- Provides research and special project support as directed by the Supervisor or Manager.
|
| |
| Qualifications: |
- Thorough knowledge of medical terminology, surgical procedures, GHI Fee Schedule and Diagnosis structure, CPT-4 and ICD-9 coding methodologies. GHI claims processing procedures, claims processing systems, contract files and service.
- Minimum typing skills of 35 wpm.
- Working knowledge of Microsoft Word and Excel
- Excellent writing and telephone skills and basic math.
- Excellent interpersonal, analytical, verbal and written communication skills required.
- Ability to work under pressure and meet stringent deadlines.
|
| |
|
|
| |  |
