Natera
Healthcare
RevCycleMedicalRecordsCaseMgr-Temp
Neural analysis suggests this role is
optimal for Mid+ candidates.
“Rev Cycle Medical Records Case Mgr-Temp at Natera. Skills: Medical records, Revenue Cycle Management, Medical necessity. Support documentation of medical necessity. Facilitate medical records collection”
What You'll Achieve.
Achieve productivity goals; Maintain highest quality standards
Industry & Context.
Problem solving; Critical thinking
Access to PHI
What They're Looking For.
Must Have
3 years relevant experience, Bachelor's Degree, Healthcare related field of study or equivalent experience
Nice to Have
Oncology or Transplant clinical setting experience
What You'll Do.
Support documentation of medical necessity
Facilitate medical records collection
Conduct client outreach
Provide expert review and interpretation
Maintain collaborative relationships
Obtain necessary medical documentation
Serve as liaison between departments
Navigate and extract data from EMR
Serve as knowledge source for MR review
Identify critical data points
Summarize information for health insurance companies
Develop working relationships with other departments
Participate in weekly meetings
Participate in daily discussions
Participate in case reviews
Participate in continuing education
Prioritize performance initiatives
Ensure productivity goals are achieved
Maintain quality of work standards
Follow department procedures
Ensure activities are documented
Conduct activities within compliance standards
Complete HIPAA training
Complete PHI privacy training
Complete General Policies and Procedure Compliance training
Complete security training
How You'll Work.
Team & Collaboration
In-house billing operations; Customer experience groups; Clinic medical records departments; Other departments impacting revenue cycle
Full Job Description
Job Description Summary The Revenue Cycle Medical Records Case Manager will support documentation of medical necessity by facilitating medical records (MR) collection and client outreach, by offering expert review and interpretation on a case by case basis, and by maintaining collaborative and productive relationships within the organization relating to Revenue Cycle Management. Job Responsibilities: Successfully obtain necessary medical documentation by collaborating with and serving as a primary liaison between in-house billing operations, customer experience groups and clinic medical records departments Have a thorough understanding and knowledge of applicable CMS, state, and insurer medical policy and coverage guidelines (in particular LCD & NCD Coverage Criteria) Ability to navigate and extract data from multiple versions of electronic medical records, including EPIC Serve as a source of knowledge for medical records (MR) review and interpretation, including in-depth review of provider progress notes and charts with the ability to identify critical data points highlighting why patient criteria meets medical necessity and summarizing in a succinct manner for health insurance companies An in-depth knowledge and understanding of oncology and organ health terminology (including chemotherapy treatments and well as immunotherapy treatments) Develop and cultivate ongoing working relationships with other departments impacting revenue cycle performance Participate in weekly meetings, daily discussions, case reviews and continuing education to review key metrics, workflows, trends, and performance improvement opportunities Prioritize performance initiatives and ensure productivity goals are achieved within a timely manner while maintaining the highest quality of work standards for Q/A Follow department procedures and ensure all activities are documented and conducted within compliance standards with applicable business process requirements and regulatory requirements Thi
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