- HCA Healthcare (Salem, VA)
- …NV, NH, NC, SC, TN, TX, UT, VA). Do you have the career opportunities as a Medical Necessity Coding Compliance Coordinator you want with your current ... a committed, caring group of colleagues. Do you want to work as a Medical Necessity Coding Compliance Coordinator where your passion for creating… more
- UnityPoint Health (Sioux City, IA)
- …+ Obtains diagnoses for lab testing performed, and determines appropriate medical necessity and coding documentation in compliance with CMS and Health ... System, receives electronic orders and completes appropriately, and determines and validates medical necessity of all lab orders in addition to obtaining… more
- Actalent (Sacramento, CA)
- …Milliman, NCCN, and ACOG, and assessing appeals for benefit coverage, medical necessity , coding accuracy, and policy compliance . You will collaborate ... NCCN, and ACOG. + Assess appeals for benefit coverage, medical necessity , coding accuracy, and policy compliance . + Collaborate with medical … more
- Emory Healthcare/Emory University (Atlanta, GA)
- …Ongoing mentorship and leadership programs + And more! **Description** The Professional Coding Compliance Auditor develops and executes audit, monitoring, and ... participates in continuing education opportunities to remain current with billing and coding compliance best practices (ie, conferences, workshops, and other… more
- Robert Half Accountemps (Cincinnati, OH)
- …Contract-to-Permanent position, you will play a critical role in ensuring the accuracy and compliance of outpatient medical coding processes. This role is ... observation cases. * Ensure assigned codes align with documented medical necessity and the reason for the...detailed reviews of medical records to ensure compliance with coding and billing standards. *… more
- Community Health Systems (Franklin, TN)
- … integrity, and working collaboratively with internal teams to support physician coding compliance and reimbursement. **Essential Functions** + Assigns accurate ... for provider education. + Familiarity with NCCI edits, LCD/NCD guidelines, and medical necessity requirements. + Strong analytical and problem-solving skills,… more
- CVS Health (IN)
- … guidelines and regulations to meet compliance requirements, such as establishing medical necessity . + In depth knowledge of medical terminology and ... codes required. + Minimum of 5 years recent and related experience in medical record documentation review, diagnosis coding , and/or auditing. + Experience with… more
- Covenant Health Inc. (Knoxville, TN)
- …Educates coding staff to proper documentation necessary to support a DRG/APC/ Medical Necessity /ROM/SOI. + Integrates documentation, coding , and proper ... staff. Working directly with the physicians, Manager of Corporate Coding Services, Director of Registration/Admitting, and medical ... billing and regulatory requirements. + Increases awareness of compliance as it relates to coding and… more
- Ventura County (Ventura, CA)
- …cases; + Provides education to the physicians on documentation requirements to establish medical necessity based on coding guidelines for assignment of ... + Reviews and evaluates policies and procedures for the Medical Records Department in relation to the overall hospital...most difficult coding cases; + Ensures VCMC coding practices are in compliance with ICD-10… more
- RWJBarnabas Health (Oceanport, NJ)
- …Regulations and Compliance Guidelines. + Critically analyzes each Medicare inpatient medical record to apply appropriate coding , DRG judgements, SOI, ROM and ... organizational average accuracy rate. Adherance to applicable Federal and State Regulations, Compliance Guidelines, and Coding Guidelines set forth by RWJBH,… more
- MedKoder (Mandeville, LA)
- About Us MedKoder, LLC is a full-service medical coding management services provider based in Mandeville, Louisiana, specializing in expert medical coding ... quality of physician documentation that supports codes selected including adherence to Medical Necessity ; + Adherence to Local Coverage Determination (LCDs), or… more
- CVS Health (Oklahoma City, OK)
- …guidelines and regulations to meet compliance requirements, such as establishing medical necessity . + Identify clinically active vs. historical conditions. + ... and directives. + Conducts self- process audits to ensure compliance with internal policies and procedures as well as...Minimum of 1 year recent and related experience in medical record documentation review, diagnosis coding , and/or… more
- AdventHealth (Orlando, FL)
- …+ Utilizes a thorough understanding of the Official Coding Guidelines, Coding Clinic guidance, medical necessity , and coverage determinations. + ... responsible for reviewing, analyzing, and interpreting clinical documentation in the medical record, applying appropriate ICD-10-CM/PCS coding conventions and… more
- Cardinal Health (San Juan, PR)
- …detection and correction of documentation, coding , and billing errors and/or medical necessity of services billed. Particular areas of focus include: ... field preferred. + 5+ years of experience in physician and/or hospital technical coding /auditing, medical necessity reviews, or related work, with oncology… more
- Integra Partners (Troy, MI)
- …them into operational requirements + Strong understanding of DME billing guidelines, medical necessity criteria, coding protocols (ICD-10, HCPCS, modifiers, ... The Medical Policy & Compliance Specialist is...protocols to interpret regulatory requirements (not day to day coding ) + Establish a structured process to proactively monitor… more
- Bozeman Health (Bozeman, MT)
- …rules, and internal policies. + Reviews medical and billing records for coding accuracy and medical necessity ; validates documentation sufficiency and ... field. + Intermediate knowledge and experience reviewing clinical documentation, billing, and coding for compliance . + Intermediate knowledge and experience with… more
- WellSpan Health (Chambersburg, PA)
- …to "ICD-10-CM Official Guidelines for Coding and Reporting" and to support medical necessity with 95% accuracy or higher. 9. Assigns appropriate first-listed ... Position Function: Under the direction of the Coding Manager, functions as a medical ...the most accurate DRG for each inpatient account, maintaining compliance based on approved coding guidelines and… more
- Northwell Health (Danbury, CT)
- …, current procedural terminology guidelines, knowledge of local coverage determination's for medical necessity , and appropriate use of modifiers. * Effectively ... diagnoses and procedures for ambulatory payment classification and for medical necessity . * Ability to code using... coding credentials in accordance with the certified coding requirements and demonstrates annual compliance . *… more
- Nuvance Health (Danbury, CT)
- …, current procedural terminology guidelines, knowledge of local coverage determination's for medical necessity , and appropriate use of modifiers. * Effectively ... diagnoses and procedures for ambulatory payment classification and for medical necessity . * Ability to code using... coding credentials in accordance with the certified coding requirements and demonstrates annual compliance . *… more
- Mohawk Valley Health System (Utica, NY)
- …+ Assign the appropriate DRG based on an analysis of the patient file and medical necessity + Assign diagnosis and procedure codes, for accurate and timely ... Job Summary Under the general direction of the Director CDI/ Coding or designee, the Medical Records Coder...physician documentation + Assist departments with diagnostic and procedural coding + Respond to Insurance, compliance and… more