PRC Claims Analyst, Purchased/Referred Care

The Mohegan Tribe Of Indians Of Connecticut; Montville (CT); Sur place; USD 52 000 - 76 000; Plein temps

Résumé du poste

The Mohegan Tribe Of Indians Of Connecticut is seeking a PRC Claims Analyst in Uncasville, CT to review, evaluate and process requests for assistance within the Tribal Purchased/Referred Care program.

Ideal candidates will have knowledge of ICD-10/CPT coding, medical terminology, and experience with EHR/billing systems; proficiency in Word/Excel and a commitment to confidentiality and organization is essential.

Qualifications

• High school diploma required.
• Three years’ experience in medical coding or billing.
• Two years’ experience with EHR or electronic billing system.
• Alternative: CPC or CPB with one year customer-facing or data-entry in medical office.

Responsabilités

• Review, evaluate and process requests for assistance for the PRC program.
• Maintain knowledge of IHS PRC programs and services.
• Apply ICD-10 and CPT coding to claims.
• Utilize EHR or electronic billing systems.
• Maintain confidentiality and strong organizational standards.

Connaissances

ICD-10/CPT coding

IHS PRC programs

Medicare/Medicaid policies

Word & Excel

EHR/billing systems

Confidentiality

Organizational skills

Medical terminology

Formation

High school diploma

CPC/CPB

Outils

Word

Excel

Description du poste

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

PRC Claims Analyst, Purchased/Referred Care

Full-Time Regular H.F.T. Uncasville, CT, US

Summary of Job Description

Incumbent in this position reviews, evaluates and processes requests for assistance made to the Tribal Purchased/Referred Care program.

• Knowledge of IHS Purchased Referred Care Programs & Services or ability to learn
• Knowledge of medical terminology, ICD-10 and CPT coding
• Knowledge of Medicare, Medicaid and other payers’ reimbursement policies and procedures
• Intermediate Word and Excel skills (skill level determined by testing)
• Strong knowledge of claims adjudication or Electronic Health Record (EHR) systems
• Strong organizational skills
• Ability to maintain strict confidentiality

Education, Experience and Training

• High school diploma
• Three (3) years’ experience in medical coding or billing
• Two (2) years’ experience with either Electronic Health Record (EHR) or electronic billing/payment system

~OR~

• High school diploma
• Certified Professional Coder (CPC) or Certified Professional Biller (CPB) or both
• One (1) year of experience in a customer-facing or data-entry role in any medical office setting

The Mohegan Tribal Government is committed to Native American Preference and is an Equal Opportunity Employer.