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Annapoorna
Zelis, Inc. - Bedminster, NJ - edits for the purpose of ensuring Zelis coding specialists can use documentation for edit support * Maintain awareness of and ensure adherence to Zelis standards regarding privacy. PROFESSIONAL EXPERIENCE/QUALIFICATIONS * Extensive knowledge of inpatient/outpatient hospital billing including UB-04s, revenue codes, itemization of charges, CPT codes, HCPCS codes, ICD-9/10 diagnosis and procedure codes, DRGs, APCs. * Knowledge of payer reimbursement policies, state and federal regulations, medical... necessity criteria and applicable industry standards. * Knowledge of commonly used medical data resources such as MDR, medical fees in the US, etc. * Knowledge of medical terminology, anatomy, and physiology. * Ability to read and abstract medical records. * Ability to develop educational materials and job aids pertaining to coding and claims. * Minimum 5+ years experience in direct patient care, medical procedure billing, medical insurance auditing, line item review, audits, coding...
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