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To apply for a position, please Use the form below to submit your cover letter and resume.
Candidates only
Please no agencies. We are currently only accepting applications on-line. Calls will not be accepted at this time.
Due to the volume of resumes we receive, we will unfortunately, only be able to respond to those candidates who most closely meet our qualifications.
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| | Location: Sacramento
Experience: 3 to 5 years
Job Description: Builds and maintains government and commercial fee schedules that are loaded into production. Analyzes various types of source information and develops semi-automated processes for converting source data into the company’s required format. Updates schedules as required.
Responsibilities:
- Converts various electronic source files including .pdf, .xls, .csv, .txt, .html, .dbf into the company standard format for loading into production.
- Builds Excel™ macros that semi-automate the conversion from source format to the company’s required format.
- Reviews source documents to determine all necessary criteria that should be included in the fee schedules including specialty, age, place of service, modifier, etc.
- Conducts an audit check of all new and revised fee schedules to ensure calculation accuracy, contract compliance, and correct coding for achieving optimum reimbursement.
- Responds to client questions or concerns about fee schedules. Investigates and provides appropriate explanation and/or resolution.
- Creates and documents procedures for maintaining and updating government payor rates (i.e. Medicaid).
- Meets and confers with other members of the NHXS team, providing coding expertise and sharing ideas for process, service and product improvements.
Qualifications:
- Experience equivalent to a Bachelor’s Degree, preferably in the Healthcare Industry.
- Must be proficient in Microsoft Office with highly advanced skills in Microsoft Excel.
- Excel skills:
- Automate commands by recording and editing Macro’s in Visual Basic
- Work with data strings, numbers, dates, and objects to import and organize data
- Automate and edit work with logic functions (IF, AND, OR, NOT)
- Create lookup functions to obtain data between worksheets (V-lookups, H-lookups)
- Create and use Pivot Tables to analyze data
- Ability to manage multiple worksheets at a time
- Linking documents
- Must be highly organized and have proven ability to solve problems through research, persistence and creativity.
- Requires exceptional customer service skills with 3 to 5 years experience working directly with customers. Must have excellent interpersonal, verbal and written communication skills (including e-mail) to support client and internal business interactions.
- Preference for candidates with a comprehensive understanding of physician, ancillary, medical and practical reimbursement. Physician coding, billing, or compliance a plus.
- Preference for candidates with a comprehensive understanding of generally recognized healthcare reimbursement rules and regulations including CPT, RBRVS, HCPCS, ICD9.
- Preference for candidates with experience auditing insurance claims with a thorough knowledge of healthplan/provider contracting and fee schedules.
Physical Demands:
- Is not required to bend, stoop or lift more than 10 pounds.
- Frequently required to sit for extended periods of time including the operation of a computer.
- Regularly required to read, write, perform basic math and operate normal office equipment.
Work Environment:
Typical office environment.
HIPAA Requirements:
- Protected Healthcare Information (PHI) includes:
- Claims
- Electronic claim data
- Payments
- Patient information (patient name, demographics, address, telephone number, any information regarding treatment or condition)
- Payor checks/EOB’s
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