Uses A/R follow up systems and reports to identify unpaid claims for collection/appeal. Gathers and verifies all information required to produce a clean claim including special billing procedures that may be defined by a payer or contract. Review and update patient registration information (demographic and insurance) as needed. Resolves claim edits as needed. Applies appr

Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD 10 CM/PCS coding and/or CPT 4 procedure coding classification systems. II. Principal Responsibilities and Tasks The following st

Requisition # 628714 Location Johns Hopkins Community Physicians, Baltimore, MD 21201 Category Finance Schedule Day Shift This is a remote position. Must reside in one of the following to be considered MD, VA, PA, DE, FL or District of Columbia. We offer a complete benefits package, paid time off, paid parental leave, paid holidays, medical, and dental insurance, short te

Under general supervision, ensures that compliance initiatives are met for all the University of Maryland Medical System (UMMS) Member Organizations. Reviews and analyzes claims data, medical records, and billing and payment information to determine if charges and reimbursement are supported according to federal and state program guidelines. Significant contributor in the

Requisition # 625171 Location Johns Hopkins Health Plans, Hanover, MD 21076 Category Non Clinical Professional Schedule Day Shift Who you are As the Vendor Auditor for Johns Hopkins Health Plans ("JHHP"), your in depth knowledge of auditing, claims, and medical policy helps ensure that our vendors are performing to policy and regulations. Not only will you lead audits, yo

Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD 10 CM/PCS coding and/or CPT 4 procedure coding classification systems. II. Principal Responsibilities and Tasks The following st