... CBCS) certification required. Role Overview: The Senior Provider Network Operations Analyst ... This role is fully remote, and the associate must be able to work Eastern Standard Time (EST) hours.
... CBCS) certification required. Role Overview: The Senior Provider Network Operations Analyst ... This role is fully remote, and the associate must be able to work Eastern Standard Time (EST) hours.
Certification in one of the following: LPN, RHIT, RHIA, CCS, CPC, or CBCS. Knowledge, Skills and Abilities * Understanding of OPPS, IPPS, ICD10 Coding, HCPCS/CPT Coding, revenue cycle processes.
Certification in one of the following: LPN, RHIT, RHIA, CCS, CPC, or CBCS. Knowledge, Skills and Abilities * Understanding of OPPS, IPPS, ICD10 Coding, HCPCS/CPT Coding, revenue cycle processes.
Certification in one of the following: LPN, RHIT, RHIA, CCS, CPC, or CBCS. Knowledge, Skills and Abilities * Understanding of OPPS, IPPS, ICD10 Coding, HCPCS/CPT Coding, revenue cycle processes.
Certification in one of the following: LPN, RHIT, RHIA, CCS, CPC, or CBCS. Knowledge, Skills and Abilities * Understanding of OPPS, IPPS, ICD10 Coding, HCPCS/CPT Coding, revenue cycle processes.
Coding Externship (Remote)- Unpaid | PAM Health Corporate
Plano, TX · On-site +1
$17.50 - $23.25/hr
Certified Billing and Coding Specialist (CBCS) f. Certified Coding Associate required (CCA) g. Registered Health Information Technician (RHIT) h. Registered Health Information Administrator (RHIA) i.
Coding Externship (Remote)- Unpaid | PAM Health Corporate
Plano, TX · On-site +1
$17.50 - $23.25/hr
Certified Billing and Coding Specialist (CBCS) f. Certified Coding Associate required (CCA) g. Registered Health Information Technician (RHIT) h. Registered Health Information Administrator (RHIA) i.
Coding Externship (Remote)- Unpaid | PAM Health Corporate
Plano, TX · On-site +1
$17.50 - $23.25/hr
Certified Billing and Coding Specialist (CBCS) f. Certified Coding Associate required (CCA) g. Registered Health Information Technician (RHIT) h. Registered Health Information Administrator (RHIA) i.
Coding Externship (Remote)- Unpaid | PAM Health Corporate
Plano, TX · On-site +1
$17.50 - $23.25/hr
Certified Billing and Coding Specialist (CBCS) f. Certified Coding Associate required (CCA) g. Registered Health Information Technician (RHIT) h. Registered Health Information Administrator (RHIA) i.
Remote Cbcs information
What is the difference between Remote Cbcs vs Remote Medical Coder?
| Aspect | Remote Cbcs | Remote Medical Coder |
|---|---|---|
| Certifications | Certified Billing and Coding Specialist (CBCS) | Certified Professional Coder (CPC) or equivalent |
| Work Environment | Medical billing, coding, and insurance claims processing | Medical coding for diagnoses and procedures |
| Industry Usage | Health insurance, billing companies, healthcare providers | Hospitals, clinics, insurance companies |
| Job Focus | Billing, claims submission, reimbursement | Assigning codes to medical records for billing and documentation |
Remote Cbcs and Remote Medical Coders both require coding certifications and work in healthcare settings, but Remote Cbcs focuses more on billing and insurance claims, while Remote Medical Coders specialize in assigning medical codes for diagnoses and procedures. Understanding these differences helps job seekers find roles aligned with their skills and certifications.
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What states have the most Remote Cbcs jobs? States with the most job openings for Remote Cbcs jobs include:
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Full-time
Posted 29 days ago
AmeriHealth Caritas rating
8.3
Based on 73 frontline employees who took The Breakroom Quiz
127th of 303 rated insurance
Job description
Job Brief
American Academy of Professional Coders (AAPC) certification (CPC, COC, CIC, CRC) or NHA (CBCS) certification required.
Role Overview: The Senior Provider Network Operations Analyst responsible for maintaining current provider data and provider reimbursement setup, and to address provider and state inquiries as they relate to claim payment issues.
Work Arrangement:
Responsibilities:
Education & Experience:
Skills & Abilities:
American Academy of Professional Coders (AAPC) certification (CPC, COC, CIC, CRC) or NHA (CBCS) certification required.
Role Overview: The Senior Provider Network Operations Analyst responsible for maintaining current provider data and provider reimbursement setup, and to address provider and state inquiries as they relate to claim payment issues.
Work Arrangement:
- This role is fully remote, and the associate must be able to work Eastern Standard Time (EST) hours.
- Candidates must have access to reliable high-speed internet (minimum 50 Mbps download / 5 Mbps upload).
- Associates in locations where required may be eligible for internet reimbursement based on applicable regulations.
Responsibilities:
- Review/approve and audits Payment Integrity (PI) vendor and internal prospective and retrospective edits/projects/recoveries
- User Acceptance Testing (UAT)/Client Review & audit (provider data, Appian Advanced Group ID (AGID) configuration, and set-up concentration) reviews requests prior to initial submission to Enterprise Operations (EO) and claims post-production
- Facets claims edit configuration concentration (Appian) - intake, review, impact assessment, and initial submission; UAT reviews requests prior to initial submission to EO and claims post-production
- Encounter error reconciliation representation, oversight and management - including identification and initiation of claim or provider changes necessary to mitigate/prevent future errors
- Management and resolution of state complaints
- State policy and contract amendment changes analysis and management
- Internal or vendor medical policy or Health Value Optimization (HVO) edit changes and initiatives
- Monitor and review state communications and changes, lead initial analysis/determination of action, provide direction on work request submissions to level I analysts, and test/audit subsequent changes
- Business Process Outsourcing (BPO) and/or other intake/workflow tool management
- Single-case agreement management/ownership, including letter development and coordination with Provider Network Management (PNM)
- Serves as the subject matter expert in State specific health reimbursement rules and provider billing requirements and as liaison to the Enterprise Operations Configuration Department
- Maintain a current working knowledge of processing rules, contractual guidelines, state/Plan policy and operational procedures to effectively provide technical expertise and business rules
- Acts as the resource to other departments by developing and managing work plans which document the status of key relationship issues and action items for high profile providers
- Performs other related duties and projects as assigned
Education & Experience:
- Associate's degree preferred, or equivalent combination of education and experience in a healthcare field.
- American Academy of Professional Coders (AAPC) certification (CPC, COC, CIC, CRC) or NHA (CBCS) certification required.
- 3 to 5 years of claims analysis experience in healthcare, managed care, or Medicaid environment preferred.
- Strong working knowledge of Microsoft Excel, Access, Word, and other MS Office tools; ability to work with pivot charts, Access databases, and data analytics.
- Claims processing and Provider data maintenance knowledge required
- Understanding of and experience related to healthcare claims payment configuration process/systems and its relevance/impact on network operations required
Skills & Abilities:
- Ability to focus on technology and business issues, as well as communicate appropriately with both technology and business experts
- Superior organizational skills required
- Critical thinking skills
- Strong customer service skills
- Data and reporting analysis
What AmeriHealth Caritas employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About AmeriHealth Caritas
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
5,001 - 10,000 Employees
Headquarters location
Philadelphia, PA, US
Year founded
1983