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Ensures proper coding of documents in accordance with the regulatorā coding guidelines and regulations.
Requirements
- ā¢Apply medical knowledge and insurance best practices
- ā¢Verify pre-approval requests (OP/IP)
- ā¢Obtain authorizations from insurance companies
- ā¢Ensure compliance with regulators' standards, claim adjudication Rules, and Business Rules
- ā¢Handle rejected pre-authorizations
- ā¢Prepare daily activity reports for management
- ā¢Assist with month-end reporting
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