- Banner Health (AZ)
- …to our award-winning patient care. POSTION SUMMARY This position evaluates medical records and assigns appropriate clinical procedure/anesthesia charges and supply ... technical Cardiology and Interventional Radiology services. CORE FUNCTIONS 1. Analyzes medical information from medical records. Accurately charge procedural and… more
- Northwell Health (Lake Success, NY)
- …to ensure physician documentation supports complete and accurate coding. Reconciles medical record documentation, coding, claims and reimbursement data to ... with coding and compliance staff in the performance of periodic physician medical record reviews. + Reconciles medial record documentation, coding, claims ,… more
- Kelsey-Seybold Clinic (Houston, TX)
- **Responsibilities** In coordination with the Senior Coder , this position reviews, interprets and verifies diagnostic, clinical, and radiation oncology codes for ... all locations ensuring that charges are supported by appropriate documentation resulting in clean claims prior to claim submission. The coder also acts as a… more
- Universal Health Services (Reno, NV)
- …enhancing the patient experience. Learn more at: https://prominence-health.com/ Job Summary: The Senior Coder is responsible for documentation and coding review ... will include pre, post and wraparound visit input. The Senior Coder will be required to work...Qualifications Qualifications and Requirements: + University/college degree, or equivalent medical records, claims or billing experience +… more
- Medical Mutual of Ohio (Centerville, OH)
- …communications (such as email, chat, and portal inquiries). . Under direction of more senior staff, conducts claims or inquiry related research. . Assists with ... **_The SDC - Claims /Customer Care Specialist - TPA position allows you...you reside within a 50-mile radius of an Ohio Medical Mutual office._** Founded in 1934, Medical … more
- Medical Mutual of Ohio (Brooklyn, OH)
- …inbound/outbound phone calls and written communications. . Under direction of more senior staff, conducts routine claims research in response to ... **Professional Certification(s):** . Healthcare field certification a plus (eg, medical terminology, certified coder /biller). **Technical Skills and Knowledge:**… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** In collaboration with the Medical Director, the Senior Medical Policy Analyst will research, analyze, evaluate, ... support the corporate philosophy, provider and member contracts, and an accepted standard of medical practice. The Senior Medical Policy Analyst will work… more
- LogixHealth (Bedford, MA)
- Location: On-Site in Bedford, MA Pu rp ose: The Senior Administrative Assistant oversees Coding/ Coding Quality policies, procedures and other operational workflows ... ps /p r ep ar es Coding Policy for coder production team and client version + Initiates CRM...dpro fi c ie ncywith MS Exc el and medical background r eq uired Coding experience and/or certification… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Annual & Quarterly HCPC/ICD10 code updates, Clinical Code Edit Solutions and Medical Cost Saving Goals. Core functions include acting as a clinician/clinical ... coder & subject matter expert (SME) for all reimbursement...policies. + Collaborates with Government Regulatory Affairs, Network Management, Medical Economics, Benefit Administration, Provider Services, Audit, IT and… more
- Highmark Health (Columbus, OH)
- …Affordable Care Act (ACA) through Hierarchical Condition Category (HCC) coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and ... and analysis. **ESSENTIAL RESPONSIBILITIES** + Conducts data analyses from medical record reviews; proactively summarizes opportunities to enhance provider… more
- Highmark Health (Columbus, OH)
- …to prevent further improper payments.Forwards case to the Credentialing and/or Medical Review Committee, law enforcement and regulatory agencies. + Develop and ... to internal and external law enforcement and regulatory agencies, Credentialing or Medical Review Committee. + Engages in delivery of audit results and overpayment… more
- CVS Health (Tallahassee, FL)
- …coding. - Advanced skills with Microsoft Excel. - Experience in healthcare/ medical insurance claims investigation or professional/clinical experience. - ... or insurance related matters; or an authorized medical professional to evaluate medical related claims . - Strong analytical and research skills. -… more
- Northwell Health (Lake Success, NY)
- …and mitigate compliance risk. Job Responsibility + Reviews data, such as claims detail, coding and medical record documentation to determine compliance ... combination of education and related experience. + Current Professional Coder Certification, or Current Coding Professional Certification required, plus specialized… more
- University of Miami (Miami, FL)
- …time Sr. Patient Accounts Representative to work in Miami, FL. The Senior Patient Accounts Representative ensures that patient demographic information is accurate ... and that funding source is billed and collected appropriately. The Senior Patient Accounts Representative uses advanced knowledge of billing procedures and coding… more
- Houston Methodist (Houston, TX)
- …changes are needed. **QUALITY/SAFETY ESSENTIAL FUNCTIONS** + Analyzes data from various sources ( medical records, claims data, payer medical policies, etc.), ... and findings to both front line team members and senior executives. + Communicates to partners, revenue cycle staff,...Integrates the payer medical policies, case specific medical documentation, and claims information into a… more
- CGI Technologies and Solutions, Inc. (Dallas, TX)
- …sound knowledge base in edit research and development in pre- and post-payment medical claims auditing in conjunction with maintaining a robust quality assurance ... implemented, may result in identification of improper payments on paid claims on behalf insurers (Clients). Research may include reimbursement regulations, payment… more