• Coder Senior

    Geisinger (Danville, PA)
    …providers into coded form procedure codes that can be utilized for submitting claims to payers for reimbursement. A joint effort between the healthcare provider and ... the coder is essential to achieve complete and accurate documentation,...procedures. Job Duties + Reviews the content of the medical record for hospital and professional inpatient or outpatient… more
    Geisinger (03/16/24)
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  • Professional Fee Coder III

    Cleveland Clinic (Cleveland, OH)
    …be able to build a life-long career with Cleveland Clinic as you can advance into Coder III, Senior Coder or Supervisor positions. At Cleveland Clinic, we ... human anatomy and physiology, disease processes and demonstrated knowledge of medical terminology. **Certifications:** + Certified Professional Coder (CPC),… more
    Cleveland Clinic (03/28/24)
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  • Inpatient Senior Medical

    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
    Northwell Health (03/23/24)
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  • Certified Senior Cardiology Interventional…

    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
    Banner Health (03/05/24)
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  • Radiation Oncology Coder

    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
    Kelsey-Seybold Clinic (03/06/24)
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  • Senior Medical Policy Analyst…

    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
    CareFirst (03/21/24)
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  • Senior Fraud and Waste Investigator

    Humana (Louisville, KY)
    …to determine audit universe and pull a statistically valid random sample of claims to be audited. Perform audit of medical documentation, survey beneficiaries ... part of our caring community and help us put health first** The Senior Fraud and Waste Professional conducts investigations of allegations of fraudulent and abusive… more
    Humana (01/11/24)
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  • Senior Manager - Payment Policy and Network…

    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
    Blue Cross Blue Shield of Massachusetts (03/10/24)
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  • SIU Senior Investigator

    CVS Health (Hartford, CT)
    …coding.- Advanced skills with Microsoft Excel.- Experience in healthcare/ medical insurance claims investigation or professional/clinical experience.- ... insurance related matters; or an authorized medical professional to evaluate medical related claims .- Strong analytical and research skills.- Proficient in… more
    CVS Health (03/17/24)
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  • Senior Investigator

    Highmark Health (Washington, DC)
    …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
    Highmark Health (03/22/24)
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  • Senior Coding Specialist-Surgery

    Cleveland Clinic (Cleveland, OH)
    …one of the most respected healthcare organizations in the world. As a Senior Coding Specialist, this position supports the mission and vision by submitting clean ... claims for the services provided. You will be responsible...place to work in healthcare. **Job Responsibilities:** + The Senior Coding Specialist is responsible for correct coding of… more
    Cleveland Clinic (03/15/24)
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  • Coding Ops Education and Appeals Consultant WFH

    HCA Healthcare (Nashville, TN)
    …and improve the quality of physician documentation within the body of the medical record to support code assignments. The Education Consultant, in collaboration with ... the Coding Manager, provides coder specific education and global coding education based on...vendor edit challenges/disputes and post bill processes for efficient claims resolution, including effective appeals for select inventory. This… more
    HCA Healthcare (02/17/24)
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  • Clinical Coding Policy Analyst

    Zelis (TX)
    …of relevant experience or equivalent combination of education & work within healthcare payers/ claims payment processing + Certified Coder (CCS, CCS-P or CPC) + ... Provide in-depth clinical coding analysis of professional and facility claims routed to the Clinical Coding Policy queue based...skills + 1+ years of experience in review of Medical Records and application of NCCI editing Education: Associates… more
    Zelis (03/04/24)
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  • Sr Patient Accounts Representative

    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
    University of Miami (03/28/24)
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  • Coding Charges & Denials Specialist (Telecommute)

    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
    Houston Methodist (02/21/24)
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  • Payment Integrity Edits Manager

    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
    CGI Technologies and Solutions, Inc. (03/27/24)
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