Texas Met on average 98%-99% of these goals and was awarded Quarterly Excellence Award for Claim accuracy. A medical examiner is a person who performs the postmortem examination to know the cause of the death of the person. Nebraska Made appropriate claim decisions based on various contracts and plan provisions. § 841-1. Coroners investigate and determine the cause of a person's death. Performed telephone and written communications to clients attorneys and providers for resolution and execution of claims such as maintaining a check register and bank reconciliation. Identify and resolve issues on claims according to established procedures, apply benefit coverage, and enter relevant information in order to process claims. Other duties of these employees are verifying claims, checking if treatments and procedures are based on the patient’s condition, and eventually authorizing or denying the claim. Logged telephone calls in system and followed up on outstanding issues. Exceeded expected quota of claims processed accurately while assuring turn around within 48 hours, through utilization of TGS and PHCS programs. The medical examiner is of two types one is the anatomical and second is the forensics pathology. Coroner or medical examiner — Duties.
Review and release medical claims for payment using CPT/ICD-9 codes; scrutinize claims for accuracy; price claims for providers with discount contracts. Direct contact with customers and providers to examine and resolve claim inquires accurately and with customer satisfaction. North Dakota
What Are the College Requirements for Becoming a Coroner? Processed commercial medial claims for PPO, EPO, Indemnity lines of business, Troubled shooting - researched benefits to obtain necessary documentation to process customer claims, Answered incoming calls and resolve claims issues for High profile accounts. He might also need to establish the time of death.
Review and determine correct ICD-9 and CPT codes, Examined claims to be processed and verified information, Outreached to MBR & LOB's internal/external customers, Reconciled and researched different databases for the purpose of making msp determinations, Determined effect capitation & health insurance claims/billing, Participated in high profile projects with time sensitive deadlines for the msp oci recon team which services both cms and kp nationally. He also provides professional documents such as autopsy, laboratory, toxicology and X-ray reports.
Supervised the installation and testing of a new software pre-pricing system resulting in a higher level of accuracy and productivity, Acted as liaison with Third Party Administrators, physicians, and insured, Processed medical claims while adjusting pricing within preferred provider group and applying specified benefits for hospitalizations.
If the body is burnt or mutilated beyond recognition, or if only skeletal remains are available, then the coroner relies on other experts to help identify the deceased. Communicated any adjustments that were generated by aging and correspondence. An upper-level examiner is called a chief medical examiner and often has other medical examiners working under him or her.
When the investigation is completed i.e. Ann. If there is a conflict or inconsistency between the functions of the coroner and the sheriff, the duties of the coroner shall be performed by the state’s attorney. ... What are the job prospects for the medical examiner? This District Medical Examiner (DME) shall investigate unattended, unusual, or traumatic deaths. An inquest is an inquiry into the manner and cause of a person’s death. Data enter HCFA 1500 Claims billed charges less than $5,000.00 and UB92 less than $30,000.00 into the system for appropriate tracking and processing. § 17-5-220; S.C. Code Ann.
Your email address will not be published. Achieved and maintained quality control levels of no less than 92% monthly. Maintain departmental standards on productivity and quality of work. like the cause of the death is determined, the medical examiner prepares the reports on that.
Chosen to analyze spreadsheets for special projects.
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