- Humana (Trenton, NJ)
- …of our caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of ... an in-depth evaluation of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis related group… more
- Centene Corporation (New York, NY)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** Perform clinical/ coding medical claim review to ensure compliance with ... coding practices through a comprehensive review and analysis of medical claims, ...directives, precedent, AMA and CMS code edit criterion + Review medical records to ensure billing is… more
- Humana (Trenton, NJ)
- …documentation + Recommend and present medical coding related education for medical record documentation guidelines + Review and respond to results from ... business results. Duties will include: + Help ensure accurate review of medical records for Medicare and...+ Provide support for establishment and monitoring of Humana's medical coding communication efforts to promote accurate… more
- Datavant (Trenton, NJ)
- …role is an opportunity to make a significant impact in the field of medical coding . You will provide essential consulting services and educational support, ... guiding healthcare professionals on improved coding practices. Collaborating closely with key stakeholders such as...strongly encouraged to apply **What You Will Do:** + Review medical records and assign precise codes… more
- Atlantic Health System (Morristown, NJ)
- …College a plus * Work Experience in the business of healthcare which includes: Medical Terminology and Coding and billing experience #LI-AW1 At Atlantic Health ... Responsible for coding quality audits of all records (outpatient, inpatient,...codes and professional fee services performed by providers from medical records according to ICD-10, CPT, HCPCS, and CMS… more
- RWJBarnabas Health (Oceanport, NJ)
- …a Bachelor s degree. + Extensive knowledge of ICD-10-CM/PCS and CPT coding , medical terminology, human anatomy and physiology, clinical indicators associated ... and Compliance Guidelines. + Critically analyzes each Medicare inpatient medical record to apply appropriate coding , DRG...goals are met for all RWJBarnabas facilities. + May review ICD-10-CM/PCS coding associated with RAC audits… more
- RWJBarnabas Health (Oceanport, NJ)
- …a Bachelor s degree. + Extensive knowledge of ICD-10-CM/PCS and CPT coding , medical terminology, human anatomy and physiology, clinical indicators associated ... and State Regulations and Compliance Guidelines. + Critically analyzes each inpatient medical record to apply appropriate coding , DRG judgements, SOI, ROM… more
- Mount Sinai Health System (New York, NY)
- **Job Description** Responsible for the review and coding of inpatient and/or ambulatory surgery records utilizing ICD-10-CM and ICD-10-PCS or CPT coding ... mix and health care statistical reporting. **Qualifications** **Education Requirements** Coding certificate, CCA. CCS (inpatient) or CCS-P (outpatient) certification… more
- Humana (Trenton, NJ)
- …In** The Coding Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for ... healthcare? Do you have a solid background in medical auditing, coding ** **,** **and medical record review ?** **If** **you answered** YES **to one or… more
- Mount Sinai Health System (New York, NY)
- …EPIC EMR system + Strong clinical and analytical skills to evaluate appropriate Medical Record Coding + Currently credentialed as CPC and/or CCS certifications ... findings with Director and staff for performance improvement. + Review accounts in various WQs to identify coding...maintain on-going coding educational sessions that address coding edits from various depts., medical necessity… more
- St. George Tanaq Corporation (Trenton, NJ)
- …Experience and Skills** + One (1) year of Medicare appeals, medical review , clinical, healthcare regulatory interpretation/application, healthcare compliance or ... Dispute Resolution Reviewer I Fully Remote*GA Job Type Full-time Description...healthcare or related discipline Additional experience in Medicare appeals, medical review , clinical, or other related experience… more
- Mount Sinai Health System (New York, NY)
- …We seek an experienced Senior Financial Analyst / CDM Chargemaster with strong medical coding expertise to support the maintenance, compliance, and optimization ... and experience + 5+ years of experience in hospital chargemaster maintenance and medical coding . + Certified Professional Coder (CPC) or equivalent credential… more
- St. George Tanaq Corporation (Trenton, NJ)
- …+ Must have 2-3 years of medical dispute resolution or Medicare appeals, medical review , clinical, or related experience in a healthcare setting + Must have ... Dispute Resolution Reviewer III Fully Remote*GA Job Type Full-time Description...review + Makes sound, independent decisions based on medical evidence in accordance with statutes, regulations, rulings, and… more
- Elevance Health (Woodbridge, NJ)
- …you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance ... of medical audit activities. + Draws on advanced ICD-10 coding expertise, mastery of clinical guidelines, and industry knowledge to substantiate conclusions. +… more
- Datavant (Trenton, NJ)
- …ICD-9/10 and HCC coding + At least 2 years of hands-on coding experience + Familiarity with medical terminology, abbreviations, pharmacology, and disease ... realize our bold vision for healthcare. As a **Supervisor, Coding Operations** , you'll play a critical leadership role...exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its… more
- RWJBarnabas Health (West Orange, NJ)
- …ICD-I0-CM/PCS proficiency required. + Extensive knowledge of ICD-10-CM/PCS and CPT coding , medical terminology, human anatomy and physiology, clinical indicators ... Regulations and Compliance Guidelines. + Critically analyzes each Managed Medicare inpatient medical record to apply appropriate coding , DRG judgements, SOI, ROM… more
- Weill Cornell Medical College (New York, NY)
- …and coding denials prevention. **Job Responsibilities** + Performs retrospective coding and documentation review of denied charges for physician services. ... status and billing guidelines to substantiate corrected claim submissions, written appeals, coding and medical necessity reviews. + Researches and interprets… more
- Intermountain Health (Trenton, NJ)
- …**Required** + Current certification through AAPC, AHIMA or HFMA, or other specialty medical coding group. + Demonstrated experience in revenue cycle and ... community connects, EPMO projects, Enterprise and system initiatives. + Performs annual review of chargemaster with clinical operations and revenue practice teams to… more
- NJM Insurance (Trenton, NJ)
- …+ Audit and process medical bills within statutory timeframes, by following medical coding guidelines and department policies and procedures + Verify correct ... compensability. + Apply state fee schedules when appropriate + Review and respond to MCS QC (Quality Control) issues...a timely manner Required Qualifications and Experience + A medical background with billing/ coding experience or education… more
- Datavant (Trenton, NJ)
- …related field + Knowledge of healthcare industry, payment models, risk adjustment, medical coding , physician workflow, and/or electronic health record systems + ... resources working closely with all internal teams including: data integrations, coding management, engineering, sales, and executive teams. + Ensure smooth… more