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| Job Role |
| Responsibilities: Accurately codes diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirements. Quality checking of coded claims. Quality checking of adjudicated claims. Advanced knowledge of Medical Coding, Medical Billing and HMO industry in USA. |
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| Medical Claims Quality Assurance Specialist |
| Instruction: Relies on instructions and pre-established guidelines to perform the functions of the job. Works under immediate supervision. Other wise relies on experience and judgment to plan and accomplish goals. Performs a variety of tasks. A certain degree of creativity and latitude is expected. Skills and Experience: Requires a bachelor’s degree in area of specialty and 0-4 years of experience in the field or in a related area. Has knowledge of commonly-used concepts, practices, and procedures within particular field. Supervision: Typically reports to a supervisor or manager. |
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