Clinical validation_Chen_Sam_2-10 yrs_Permanent

Arminus - Chennai, Tamil Nadu - Job Description :Job Description: Perform daily clinical validation reviews on client data for completeness and accuracy of coding procedures and diagnoses, as well as, modifiers utilizing both coding and clinical background to ensure appropriate Job Description : Job Description: Perform daily clinical validation reviews on client data for completeness and accuracy of coding procedures and diagnoses, as well as, modifiers utilizing both coding and clinical background to ensure appropriateness for reimbursement. Review provider appeals based on received documentations utilizing coding and client specific guidelines. Contribute by providing feedback on possible changes to enhance system/clinical validation and appeals review process and efficiency. Identify Claims that are incorrect or are inconsistent with the rules and requirements provided Maintains production goals and quality standards set by the audit for the auditing concept. Audits against the expected level of quality and Key...

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