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OverviewGuidehouse is a leading global provider of consulting services to the public sector and commercial markets, with broad capabilities in management, technology, and risk consulting. By combining our public and private sector expertise, we help clients address their most complex challenges and navigate significant regulatory pressures focusing on transformational change, business resiliency, and technology-driven innovation. Across a range of advisory, consulting, outsourcing, and digital services, we create scalable, innovative solutions that help our clients outwit complexity and position them for future growth and success. The company has more than 12,000 professionals in over 50 locations globally. Guidehouse is a Veritas Capital portfolio company, led by seasoned professionals with proven and diverse expertise in traditional and emerging technologies, markets, and agenda-setting issues driving national and global economies. For more information, please visit www.guidehouse.com. ResponsibilitiesThe Third Party Specialist performs a variety of duties related to the processing of a charge correction. Such duties may include, but are not limited to the following:
- Process business office charge corrections as assigned in electronic medical record, hard copy request, or reports.
- Prepare corrected claim forms and reports refunds.
- Ensure all requests are accurate and compliant in nature.
- Perform other duties as requested by Supervisor/Manager.
- Prepares, validates and performs any corrections required for the business office activity
- Assigns required CPT/ICD/ASA/ HCPCS codes and/or modifiers as needed per documentation
- Identifies missing information and gives to appropriate party for follow up
- Has specific job knowledge to perform assigned job functions, including all applicable computer programs
- Attends required in-service training, various committees, department and other appropriate meetings related to the busines office, coding, etc.
- Maintains billing requirements for all carriers when filing corrected claims
- Works with management to ensure workflow is maintained and efficient
- Meets or exceeds productivity and quality standards
- Openly exchanges information with co-workers in a timely manner
- Respects the confidentiality of information in the workplace
- Provides coding/technical guidance to physicians and other departmental staff in identifying and resolving issues or errors, such as incomplete or missing records and documentation, ambiguous or non-specified documentation, or codes that do not conform to approve coding principles/guidelines
- Ensures all written communication is grammatically correct and checks for typographical errors
- Provides guidance to business office team, Third Party, billing contacts and other departmental staff regarding any issues related to charge corrections
- High school diploma or equivalent
- Excellent written and oral communication skills
- Strong computer skills
- 1-2 years previous medical coding experience
- CPC or CCS-P certification
- The successful candidate must not be subject to employment restrictions from a former employer (such as a non-compete) that would prevent the candidate from performing the job responsibilities as described.
- Due to our contractual requirements, to be eligible for this role, you must be fully COVID-19 vaccinated at time of hire.
- Medical, Rx, Dental & Vision Insurance
- Personal and Family Sick Time & Company Paid Holidays
- Position may be eligible for a discretionary variable incentive bonus
- Parental Leave and Adoption Assistance
- 401(k) Retirement Plan
- Basic Life & Supplemental Life
- Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
- Short-Term & Long-Term Disability
- Tuition Reimbursement, Personal Development & Learning Opportunities
- Skills Development & Certifications
- Employee Referral Program
- Corporate Sponsored Events & Community Outreach
- Emergency Back-Up Childcare Program