- familycarecenter (Nashville, TN)
- …in compliance with State and Federal regulations, clinical necessity , and appropriate coding standards. Performs pharmacologic treatment strategies, ... financial security. Enjoy a full suite of competitive benefits, including medical , dental, fertility, retirement, wellness, profit sharing and more. Annual… more
- HCA Healthcare (Hermitage, TN)
- …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
- 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 (Nashville, TN)
- … guidelines and regulations to meet compliance requirements, such as establishing medical necessity . + In depth knowledge of medical terminology and ... required + Minimum of 2 years recent and related experience in medical record documentation review, diagnosis coding , and/or auditing **Preferred… more
- CVS Health (Nashville, TN)
- …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
- Datavant (Nashville, TN)
- …Monitor and manage denials throughout the entire revenue cycle, including registration, eligibility, coding , billing, and medical necessity . + Analyze denial ... denials across the entire revenue cycle to ensure optimal reimbursement and compliance with payer regulations. This role requires in-depth knowledge of healthcare… more
- Highmark Health (Nashville, TN)
- …and in writing when the information provided is not adequate to make a medical necessity determination. + Escalate appropriate cases to leadership that require a ... computer skills + 3 years of work experience in medical terminology **Preferred** + Work experience with ICD-9 and/or...terminology **Preferred** + Work experience with ICD-9 and/or CPT coding **Skills** + Compliance with all regulatory… more
