- University of Miami (Hialeah, FL)
- …review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Concurrent Quality Reviewer of our hospital ... reviews documentation in the electronic medical record (EMR) and ensures that accurate assignment and...CDIs, Coders, Quality, and other relevant multidisciplinary teams. The concurrent inpatient quality reviewer will assign a… more
- Fresenius Medical Center (Plano, TX)
- **PURPOSE AND SCOPE:** + The Coder performs data entry processing within the assigned function(s). The incumbent is responsible for applying appropriate diagnostic ... for utilization in data retrieval, analysis and claims processing. The Coder provides administrative support in the interpretation and explanation of data… more
- Trinity Health (Boise, ID)
- …transition needs. Reassesses, monitors, and modifies transition needs as appropriate. Conducts concurrent medical record review using established medical ... **Description:** **GENERAL SUMMARY AND PURPOSE:** Provides hospital case management/utilization review and discharge planning collaboratively determining level of care… more
- Queen's Health System (Honolulu, HI)
- …and completeness of clinical documentation throughout The Queen's Health Systems, through concurrent medical records reviews and query process. * Responsible for ... the concurrent review of provider documentation to ensure...team to ensure integrity and completeness of documentation and code assignment for the purposes of appropriate reimbursement, risk… more
- UPMC (Wexford, PA)
- …as reports that summarize outcome of special projects. + Perform internal retrospective, concurrent or prospective medical chart audits to assure that CPT codes ... be their best selves? UPMC Children's Community Pediatrics is hiring a Full-Time Medical Auditor, Compliance to support the office Remotely. Must live in the state… more
- Atlantic Health System (Summit, NJ)
- …information from patient records, to accurately reflect the patient's encounter. *Reviews CDI concurrent review notes and works with the CDI Team to ensure ... optimal code capture on all cases. Ensures optimal reimbursement in...reimbursement reporting requirements *Works with their assigned Lead to review coding questions and engage in coder … more
- Actalent (San Antonio, TX)
- …successful completion of cases. Essential Skills + Experience in utilization management, concurrent review , prior authorization, utilization review , case ... + Proficiency with InterQual. + Active TX RN License. + Utilization Management/ Concurrent Review experience. + ICU/ER experience. + Strong communication skills.… more
- SUNY Upstate Medical University (Syracuse, NY)
- …and medical concepts. This is achieved by both thorough comprehensive concurrent and retrospective medical record review for accuracy, specificity, ... (CDI) Specialist primary responsibility is to ensure the inpatient medical record accurately supports severity of illness and risk...the inpatient coding team to ensure the assigned final code set is reconciled pre-bill, when necessary, to resolve… more
- Veterans Affairs, Veterans Health Administration (Fayetteville, NC)
- …overall quality and completeness of clinical documentation. Inpatient CDI focuses on the concurrent review of patient records with an emphasis on improving ... Management section at the Fayetteville NC VA Coastal Health Care System. MRTs ( Coder ) are skilled in classifying medical data from patient health records… more
- Kaleida Health (Buffalo, NY)
- …the clinical documentation. Facilitate modifications to clinical documentation through concurrent interaction with physicians/clinical staff, Medical Directors, ... **Clinical Documentation Specialist Outpatient** **Location:** Buffalo General Medical Center Location of Job: US:NY:Buffalo Work Type: Full-Time **Shift:** Shift 1… more
- Covenant Health Inc. (Knoxville, TN)
- …the validity and reliability of the case-mix index, CDI is accountable for concurrent review of health records, reviewing documentation that supports the ... reviews in the setting of an acute care facility. Concurrent reviews assure the completeness of medical ...to help link ICD-10-CM and ICD-10-PCS coding guidelines and medical terminology to improve accuracy of final code… more
- Trinity Health (Davenport, IA)
- …consultant. Facilitates the overall quality, completeness, accuracy and integrity of medical record documentation through extensive record review . Through ... members of the healthcare team, achieves appropriate clinical documentation to support code assignment, medical necessity, severity of illness, risk of mortality… more
- GE Vernova (Schenectady, NY)
- …Technical Director, Generation Products & Services team with focus on Grid Code Testing, within the Consulting Services organization, working across several other ... development of GE product/service offerings and support New Product/Technology Introductions concurrent with GE business needs. + Support domestic and global… more
- Pacificorp (Portland, OR)
- …complexities of disability and/or state disability leaves of absence claims, and their concurrent leave claims (eg Family Medical Leave Act, State Paid Leaves, ... timely and accurate communications. **Responsibilities** * Evaluate and analyze medical information pertaining to employees' eligibility status, medical … more
- Nuvance Health (Danbury, CT)
- …inpatient by the attending, and case does not meet criteria per first level medical necessity review , discuss case with the attending MD to gather additional ... days, or more frequently if criteria are waning. Sends concurrent reviews to payor upon request. 11)Ensures all days...14) Notifies care team, when patient is not meeting medical necessity per InterQual or MCG review … more
- Beth Israel Lahey Health (Burlington, MA)
- …care being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure criteria for ... people's lives.** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status based on… more
- CareOregon (Portland, OR)
- …and provider education. + Develop and manage chart retrieval projects for prospective, concurrent and retrospective chart review programs. + Serve as Account ... sharing provider education and tracking progress toward goals. Chart Review & Vendor Oversight + Develop and oversee coding...Education Required + Minimum 7 years' experience as certified coder + Certified Risk Adjustment Coder (CRC),… more
- UPMC (Pittsburgh, PA)
- …Actively participates in the daily utilization management and quality improvement review processes, including concurrent , prospective and retrospective reviews, ... Physicians must devote sufficient time to the CHC-MCO to provide timely medical decisions, including after-hours consultation, as needed + Provide leadership and… more
- Banner Health (Phoenix, AZ)
- …plans in the areas of prior authorization, census management, prospective/ concurrent /retro review , and appeals. Care management: Coordinating/reviewing the ... Decision Making **Work Shift:** Day **Job Category:** Physicians The Senior Medical Director, Network Performance is a senior clinical executive responsible for… more
- Catholic Health Initiatives (Chattanooga, TN)
- …American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC) required. Professional Medical Auditor Certification (CPMA) ... **Overview** **CHI Memorial Mountain Management** CHI Memorial Medical Group (Mountain Management Services), now part of...for the purpose of accurately reporting HCC's. Prospective and concurrent reviews will account for 70% of the workload… more