To apply, CLICK HERE.
Duties and Responsibilities
- Performs post payment analysis of medical claims and records.
- Uses independent judgment to determine sanction level, and forwards recommendation to management for approval.
- Prepares reports and correspondence.
- Researches policy/ standards.
- Meets established production requirements consistently.
- Demonstrates and understand of the skills needed, but needs coaching
State Plan / Department Specific Duties and Responsibilities
- Close assigned cases.
- Demonstrates consistent movement of cases towards closure.
- Demonstrates good quality work in conjunction with efficient case movement.
- Demonstrates knowledge and understanding of SURS procedures and process.
- Contributes a positive attitude in order to meet goals.
- Utilizes J-SURE (or equivalent) system with minimum assistance.
Knowledge, Skills and Abilities
- Strong analytical skills.
- Computer knowledge including Microsoft Word and Excel.
- Knowledge of coding, billing, and chart review experience.
- Excellent verbal and written communication.
- Ability to abide by DXC's policies.
- Ability of maintain attendance to support required quality and quantity of work.
- Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
- Ability to establish and maintain positive and effective work relationships with coworkers, clients, member, providers and customers.
- Participates in teams necessary for department goals.
- Associates Degree in Nursing
- 2 years nursing experience
- Current Louisiana RN license
- CPT/ICD-9 coding experience