- 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
- 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
- Northwell Health (Westbury, NY)
- …standards are maintained in compliance with Federal and State regulations. + Applies coding rules and regulations to the validation review process. + Reviews ... clinical staff and nursing supervisors in providing appropriate documentation in the Medical Record. + Identifies appropriate coding changes necessary to provide… 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
- Veterans Affairs, Veterans Health Administration (Bronx, NY)
- …records and health information systems demonstrating a knowledge of medical terminology, medical records procedures, medical coding , or medical , ... multiple HIM reports. They participate in various health record review activities to ensure the integrity of the health...employment as an MRT/MRA or related field such as medical coding , qualitative and quantitative health record… 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
- Northwell Health (Garden City, NY)
- …or written chart. Ensures medical record is accurate, complete and meets medical coding requirements. Assists in coordinating organization of care to meet ... required lab results and documentation are available in the medical record for practitioner review (for practices...at an approved school, required. * Working knowledge of medical terminology, CPT and ICD-9 coding , required… 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
- 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
- BronxCare Health System (Bronx, NY)
- …public perception of BronxCare Health System and its employees. Qualifications - 1-2 Years Medical Records Coding experience - CCS or CPC Required - High school ... Overview Review clinical documentation and diagnostic results as appropriate...procedures as documented in the ICD-10-CM Official Guidelines for Coding and Reporting. Resolve error reports associated with billing… 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
- Molina Healthcare (Yonkers, NY)
- … Claims Review . + Minimum two years of experience in Claims Auditing, Medical Necessity Review and Coding experience + Familiar with state/federal ... DESCRIPTION** **Job Summary** Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate… more
- Mount Sinai Health System (New York, NY)
- …documentation issues, develop targeted provider education, and create best practices for medical record review and diagnosis code abstraction. The incumbent will ... to determine, analyze and solve escalated issues related to medical record documentation and coding deficiencies required....evaluates documentation and query tools with CDQI staff and medical care teams. Conducts annual review of… more
- Weill Cornell Medical College (New York, NY)
- …range for this role when Hired for NYC Offices **Position Summary** Performs coding activities and is responsible for reviewing medical records for ... to ensure claims are being coded appropriately. + Performs coding and documentation review prior to charge... prior to charge entry for physician services. Reviews medical record and super-bill documentation for completeness and accuracy… more
- Northwell Health (Garden City, NY)
- …standards are maintained in compliance with Federal and State regulations. 5.Applies coding rules and regulations to the validation review process. 6.Reviews ... - BSN or MSN candidates with a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Validates Acute Inpatient coded charts… more
- Molina Healthcare (New York, NY)
- …policies, CPT guidelines, internal policies, and contract requirements. This position completes a medical review to facilitate a referral to law enforcement or ... **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving...and resolving instances of healthcare fraud and abuse by medical providers. This position uses information from a tip,… more
- Mount Sinai Health System (New York, NY)
- …GED required. Associate degree preferred. + 1-2 years of experience in medical practice/outpatient coding /payment/charge posting preferred. + Excel, Typing and ... data and ensure proper reimbursement for services provided and in compliance with coding , payment rules and regulations. **Qualifications** + High School Diploma or… more
- WMCHealth (Valhalla, NY)
- …and reports to the the coding leadership team. + Participates in mandated medical record review processes. + Using current ICD10 CM/PCS coding systems, ... is responsible for addressing appeals to insurance companies and coding highly complex medical records using the...to insurance companies and coding highly complex medical records using the current International Classification of Diseases… more