Coding & Claims - Coordinator 1
Company: The University of New Orleans
Location: Baton Rouge
Posted on: May 8, 2024
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Job Description:
Thank you for your interest in The University of New
Orleans.
Once you start the application process, you will not be able to
save your work, so you should collect all required information
before you begin. The required information is listed below in the
job posting.
You must complete all required portions of the application and
attached the required documents in order to be considered for
employment.
Department
Design and Covered Services
Job Summary
Job Description
--- Reviews and verifies accurate CPT, ICD-10, HCPCS reimbursement
between the MCO and Providers
--- Prepares and analyzes reports on such topics as number of
denied claims, documentation or coding issues, for review by
management
--- Reviews all documentation assigned for completeness, accuracy,
and compliance
--- Ensure contract compliance by each managed care organization
(MCO), as well as timely and responsive MCO and provider
support.
--- Provides technical guidance to providers, external
stakeholders, and MCOs to improve the reimbursement process and to
address Medicaid programmatic issues to lessen provider
abrasion.
--- Serve as liaison with the MCOs and LDH MMIS, Eligibility and
Systems staff to address questions and complaints related to claims
issues.
--- Maintains knowledge of HIPAA guidelines and regulations.
--- Review monthly denied claims reports and provide analysis to
provider relations program manager.
--- Act as the department resource for coding questions and
training
--- Review Network Adequacy reports and keep up with CMS
guidelines
--- Assists with administering the provider independent review
process to ensure that claim disputes are resolved in compliance
with the requirements and timelines established by Act 349 of the
2017 Regular Legislative Session.
--- Assists with oversight of the medical necessity vendor contract
and prepares the agenda, minutes, and data for the required
Independent Review Panel meetings.
--- Serves as technical lead for the implementation of a provider
network adequacy analytics tool.
--- Manages the MCO policy submission process, including
operationalizing Act 319 of the 2019 Regular Legislative Session,
which includes researching managed care and fee-for-service
policies, Informational Bulletins/Health Plan Advisories, and state
rule, as well as tracking these policies through the approval
process.
--- Perform other tasks as directed.
Required Qualifications:
--- Bachelor's Degree, or 6 years of professional experience in
lieu of degree.
--- Excellent analytical skills, effective organizational and time
management skills.
--- Able to independently initiate communication with
stakeholders.
Desired Qualifications:
--- Bachelor Degree in Public Health, Community Health or
Healthcare Management.
--- Minimum 1 year of experience with Medicaid program support or
working with insurance/Medicare.
--- Minimum 1 year of experience in reporting and statistical
analysis.
--- Working knowledge of provider claims, such as claims submittal
requirements, posting payments, recoupments and working
denials.
--- Certificate in medical coding (AHIMA or AAPC).
Required Attachments
Please upload the following documents in the Resume/Cover Letter
section.
See Diversity Statement instructions by clicking this link:
https://www.uno.edu/careers/diversity-instructions
Applications that do not include the required uploaded documents
may not be considered.
Posting Close Date
This position will remain open until filled.
Note to Applicant:
Applicants should fully describe their qualifications and
experience with specific reference to each of the minimum and
preferred qualifications in their cover letter. The search
committee will use this information during the initial review of
application materials.
References will be contacted at the appropriate phase of the
recruitment process.
This position may require a criminal background check to be
conducted on the candidate(s) selected for hire.
As part of the hiring process, applicants for positions at the
University of New Orleans may be required to demonstrate the
ability to perform job-related tasks.
The University of New Orleans is an Affirmative Action and Equal
Employment Opportunity employer. We do not discriminate on the
basis of race, gender, color, religion, national origin,
disability, sexual orientation, gender identity, protected Veteran
status, age if 40 or older, or any other characteristic protected
by federal, state, or local law.
Keywords: The University of New Orleans, Kenner , Coding & Claims - Coordinator 1, Other , Baton Rouge, Louisiana
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