Job Description :
New Request-ID: 3657-1
Position: HVI - Clinical Healthcare Products - USA-Consultant-HVI
Location: Onsite-Orlando, FL
Duration:10 months contract
Time to Book:1424.00
Job Description: Bachelor''s Degree. And 2+ years directly related experience
Role Description:
Scheduling Considerations: This will be a full time resource
Healthcare Business detail knowledge:
Detailed understanding of US and Canadian Revenue cycle management
o US HIPAA / CAN Ministry regulations
o ICD, HCPCS and CPT coding
o Medical Necessity and CCI edits
o Unique provider requirements
DME
ESRD
Canadian Hospitals
Billing
o Medicare, Medicaid (50 states) – CMS rules and regulations
o MOH/MSP, WSIB, Interprovincial
o Insurance - ~10 major payors (ex. BCBS, VA, Cigna, Tricare, Champus, Humana) and several thousand separate payor/plans with different adjudication methodologies)
o Private payment – self pay, deductibles, co-insurance
o Contracts
Industry IT formats
o CMS-1500
o X12 formats – 837 billing, 835 reimbursement, 270 & 271 eligibility, 276 & 277 claim status
o MOH/MSP/WSIB billing and reimbursement
o HL7 integration
Custom Vendor integration
o Cerner, McKesson, Epic, Change Healthcare
o Clearinghouses, banks
Client specific application integration methodologies
Healthcare Financial accounting
Technical expert abilities:
HRCM schema table detailed knowledge
o Object relationships
o Healthcare specific table and field understanding
Oracle database knowledge
o Windows and Unix/Linux implementations
o SQL developer tools
o Database triggers, views, packages, procedures, functions
o Other database objects maintenance, tuning, debug setup and control
Oracle PL/SQL complex development functionality
o Triggers, views, packages, procedures, functions development
Crystal reporting complex forms and reports
o Oracle SQL
o Images in forms
o Drill down reporting
o Master / detail reporting
Excel development
Application implementation process:
Solutions design and development
User training
Project planning and implementation
Go-live support
HVI/Lawson Healthcare Products/Technical & Functional/HVI Clinical Bridge
Additional Skills: HVI/Lawson Healthcare Products/Technical & Functional/HVI Clinical Bridge