- PruittHealth (Norcross, GA)
- …and skills; Seeks and responds to regular performance feedback from team lead and provides upward feedback, as needed. 15.Assists in orientation and appropriate ... with members of own and other teams to communicate effectively and ensure compliance with cross-team responsibilities. 17.Carries out all duties with a Commitment to… more
- Astrana Health, Inc. (Houston, TX)
- Risk Adjustment Coding Specialist II (Houston, TX) Department: Quality - Risk Adjustment Employment Type: Full Time Location: 19500 HWY 249, Suite 570 Houston, TX ... are currently seeking a highly motivated Risk Adjustment Coding Specialist . This role will report to a Sr. Manager...diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk… more
- Trinity Health (Howell, MI)
- …online systems. Identifies non-routine complex issues and escalates to Patient Access Lead for resolution. Assists in the training and education of colleagues upon ... ongoing as new systems and processes are created. Maintains compliance with HIPAA and other regulatory requirements throughout all...in special projects as directed by the Patient Access Lead . Other duties as needed and assigned by the… more
- Fallon Health (Worcester, MA)
- …product regulatory requirements and Program policies and processes o Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing ... to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)-… more
- Pair Team (Sacramento, CA)
- …Team, we're an innovative, mission-driven company reimagining how Medicaid and Medicare serves the most underserved populations. As a tech-enabled medical group, ... - we're building the future of more equitable, community-driven healthcare. Our Values Lead with integrity: We keep our commitments and take responsibility for our… more
- CERiS (Fort Worth, TX)
- …and driving process improvements to enhance coding accuracy, documentation completeness, and compliance . The Director leads a team of clinical and coding auditors ... daily activities of the team. Team Leadership & Development: Lead , mentor, and develop a high-performing team of DRG...and provide regular feedback through one-on-one and team meetings. Compliance & Quality Assurance: Serve as a subject matter… more
- GRIFOLS, SA (Kansas City, KS)
- …Center and Hospital accounts like pharmacy DOP and Emergency Room. As the sales lead for a given geography(territory) the SSR will need to work cross functionally to ... clinical insights aligned with the product's label to relevant customers. * Lead in-depth discussions requiring an advanced comprehension of product knowledge,… more
- BlueCross BlueShield of North Carolina (NC)
- …complex coding patterns and reports relevant data to the Centers for Medicare and Medicaid Services (CMS). **What You'll Do** + Analyzes necessary documentation, ... coding and reports relevant data to the Centers for Medicare and Medicaid Services (CMS). + Uses all resources...Medicaid Services (CMS). + Uses all resources to ensure compliance and understanding of the CMS Hierarchical Condition Category… more
- PruittHealth (Norcross, GA)
- …concepts, and skills; Seeks and responds to regular performance feedback from team lead and provides upward feedback, as needed. 15. Assists in orientation and ... with members of own and other teams to communicate effectively and ensure compliance with cross-team responsibilities. 17. Carries out all duties with a "Commitment… more
- Trinity Health (Livonia, MI)
- …and periodic risk assessments in support of the Trinity Health Integrity & Compliance Program (ICP). Risk assessments consider legal and regulatory compliance ... Health & Human Services (DHHS) - Office of Inspector General (OIG), Centers for Medicare & Medicaid Services (CMS), Department of Justice (DOJ) as well as input… more
- HonorHealth (AZ)
- …competencies include project management, clinical trial operations, coding/billing compliance , Medicare coverage analysis/budgeting, contracting, Clinical Trial ... basic finance and accounting principles. The successful Senior Clinical Trial Operations Specialist will lead and coordinate the activities of a… more
- Aveanna Healthcare (Dallas, TX)
- Healthcare Administrative Specialist ApplyRefer a FriendBack Job Details Requisition #: 205019 Location: Dallas, TX 75287 Category: Administrative/Clerical Salary: ... $13.00 - $15.00 per hour Position Details Position: Operations Specialist (Medical Records Specialist ) Join a Company That Puts People First! Aveanna Healthcare… more
- Molina Healthcare (Vancouver, WA)
- …supports continuous improvement of intervention processes and outcomes. Acts as a lead specialist within the department and/or collaboratively with other ... departments. **Job Duties** + Acts as a lead specialist to provide project, program, and/or initiative related direction and guidance for other specialists… more
- WellSpan Health (York, PA)
- …Peer Specialist . + Completes no less than 8 billable shadowing hours with a Lead Certified Peer Specialist . + Completes and passes the required PCB exam for ... Life Skills training. + Completes a 75-hour approved Peer Specialist training within 8 weeks of hire date. +...strategies. + Completes yearly annual safety education modules in compliance with WellSpan Philhaven policy. + Performs and participates… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... achieve that purpose. Job Summary The Customer Solution Center (CSC) Audit Readiness Specialist II is responsible for the execution, oversight, and monitoring of the… more
- Trinity Health (Albany, NY)
- …Type:** Full time **Shift:** Day Shift **Description:** Risk Adjustment Coding Specialist -St. Peter's Health Partners - Full-time - Remote **POSITION PURPOSE:** ... The Risk Adjustment Coding Specialist works in a team environment and is responsible...adhering to coding guidelines established by the Centers for Medicare and Medicaid Services (CMS). **SKILLS, KNOWLEDGE, EDUCATION AND… more
- Organon & Co. (Plymouth Meeting, PA)
- …highly skilled and experienced professional to join our team as the Senior Specialist of Contract and Reimbursement Strategy. This role is essential in developing ... in facility and healthcare provider reimbursements by payer type, including commercial, Medicare , and Medicaid. The role will also support the development of a… more
- Cleveland Clinic (Garfield Heights, OH)
- …a rewarding, lifelong career in a diverse and welcoming environment. As a SQPE Specialist II, you will lead safety, quality and experience efforts by focusing ... A caregiver in this role serves as a Stroke Coordinator-ensuring compliance with stroke certification standards and promoting continuous improvement-and supports… more
- Trinity Health (Westerville, OH)
- …relation between diagnosis and procedure using CPT and ICD-9 coding to ensure compliance with third party regulations. Understands Medicare , Medicaid and other ... Full time **Shift:** **Description:** **Position Purpose:** + Patient Financial Specialist I; Ensures the collection of accurate and complete registration/admission… more
- Trinity Health (Columbus, OH)
- …relation between diagnosis and procedure using CPT and ICD-9 coding to ensure compliance with third party regulations. Understands Medicare , Medicaid and other ... 8:00 am - 4:30** **pm.** **Position Purpose:** + Patient Financial Specialist I; Ensures the collection of accurate and complete registration/admission information… more
