- LE Cox Medical Centers (Lake Spring, MO)
- …This position interprets and analyzes medical records to ensure billing accuracies. Reviews coding on healthcare claims in order to reimburse from the ... coding guidelines and the ability to apply coding guidelines when reviewing documentation in the medical... coding guidelines when reviewing documentation in the medical record. ▪ Must have experience with detailed knowledge… more
- CornerStone Staffing (Fort Worth, TX)
- …benefit verification, prior authorization, and coverage guidelines * Experience with collections on medical claims PREFERRED SKILLS * Prior work with claims ... W2, Temporary (6 months) * Start: ASAP ROLE IMPACT Join a leading healthcare network to ensure accurate and compliant billing across multiple service lines,… more
- Commonwealth Care Alliance (Boston, MA)
- …under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible ... Degree **Required Experience (must have):** + 7+ years of Healthcare experience, specific to Medicare and Medicaid + 7+...Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding … more
- Molina Healthcare (Caldwell, ID)
- …diagnosis-related group (DRG) validation tools and process improvements - ensuring that member medical claims are settled in a timely fashion and in accordance ... auditing, quality assurance, recovery auditing, DRG/clinical validation, utilization review and/or medical claims review, or equivalent combination of relevant… more
- CGI Technologies and Solutions, Inc. (Charlotte, NC)
- …roles, leading projects and teams . 5 years of experience in healthcare claims adjudication, medical coding , DRGs, and/or reimbursement methodologies . 5 ... long-term relationships with key client stakeholders, including executive leadership, claims operations, finance, compliance, and clinical teams. * Lead client… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …3 years of relevant health plan or provider office medical coding / claims and/or Business Analyst experience in a healthcare setting applicable to ... In this role, you will be responsible for ensuring healthcare medical coding and reimbursement...claims adjudication. This includes analysis of changes to medical code sets to determine impacts to and necessary… more
- HCA Healthcare (Hermitage, TN)
- …NC, SC, TN, TX, UT, VA). Do you have the career opportunities as a Medical Necessity Coding Compliance Coordinator you want with your current employer? We have ... of colleagues. Do you want to work as a Medical Necessity Coding Compliance Coordinator where your...substitute education requirements. + Minimum 3 years of hospital coding experience preferred. + Minimum 5 years healthcare… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Senior Healthcare Coding Analyst Location: Hybrid | Eagan, Minnesota Career Area: ... and Blue Shield of Minnesota is hiring a Senior Healthcare Coding Analyst in Eagan, MN. In...lead and coordinate internal and external activities related to medical coding projects. This position plays a… more
- HCA Healthcare (Nashville, TN)
- …experience required + RHIA, RHIT and/or CCS preferred Please visit our Parallon HCA Healthcare Coding Landing Page for more information on Coding ... in Company and HSC policy + Reviews all official data quality standards, coding guidelines, Company policies and procedures and clinical/ medical resources to… more
- Sharp HealthCare (San Diego, CA)
- …Auditor will analyze and assess Sharp's potential risks using SHC's billing and coding claims data, risk assessment data, MDAudit risk analyzer software, OIG ... Sharp HealthCare 's (SHC) compliance audit function and maintaining Sharp HealthCare 's view of coding , billing and reimbursement compliance audits. **Required… more
- Guidehouse (San Marcos, CA)
- …or customer service. + Working knowledge can be of the following: insurance claims , billing, coding , follow-up, finance, accounting or customer service related ... Required** **:** None **What You Will Do** **:** The ** Medical Biller** is expected to perform all areas of...billing, and payer audit follow-up for government and non-government claims . Must work with other departments to facilitate the… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …data. Essential Accountabilities: Level I . Analyzes and audits acute inpatient claims . Integrates medical chart coding principles, clinical guidelines, ... of medical claims billing/payment systems, provider billing guidelines, medical necessity criteria, and coding terminology. . Coding Certification… more
- Molina Healthcare (Milwaukee, WI)
- … Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position uses ... to law enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of … more
- Hartford HealthCare (Farmington, CT)
- …appropriateness of patient charges, and Charge Description Master (CDM) assigned HCPCS/CPT coding , by reviewing the medical record, facility protocol, and other ... every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in...and resolve specific billing edits and denials that require coding and billing expertise with some clinical knowledge that… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …demands and strict timelines in a fast-paced environment + A proficient understanding of medical coding and medical record reviews + Demonstrated analytical ... Fraud Investigation & Prevention Unit ("FIP"). The position will be a dedicated coding specialist reviewing medical records to identify instances of health care… more
- Humana (Oklahoma City, OK)
- …part of our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records ... and receives guidance where needed. Follows established guidelines/procedures. The Medical Coding Auditor confirms correct CPT ...Home Health, and minor procedures + Experience with the Claims Life Cycle + Experience with coding /auditing… more
- Houston Methodist (Houston, TX)
- …and capture potential revenue opportunities. This position performs quality assurance, detailed claims analysis, and medical record reviews of complex claims ... At Houston Methodist, the Sr Compliance Coding Analyst position is responsible for supporting accurate...Conducts risk-based and baseline reviews of complex and escalated claims or records in a timely manner, evaluates corrective… more
- Ideal Home Care (Islandia, NY)
- …with healthcare regulations. Key Responsibilities: + Curriculum Delivery: Teach medical billing and coding courses, including healthcare terminology, ... ICD-10, CPT, HCPCS coding systems, insurance claims , reimbursement processes, and regulatory compliance. + Instructional Methods:...+ Minimum of 2 years of professional experience in medical billing, coding , or healthcare … more
- Elevance Health (Hanover, MD)
- …spending. The **DRG CODING AUDITOR** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit ... you will make an impact:** + Analyzes and audits claims by integrating medical chart coding...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- Prime Healthcare (Ontario, CA)
- …to all levels using Microsoft Office applications. + Strong knowledge of medical coding (ICD-10, HCPCs/CPT, etc.) Preferred qualifications: + Certified ... to improve the quality and minimize process cost of Claims for all Prime Healthcare 's self-insured Employee...Professional Coding Certification, AIC, ARM, or equivalent. + Familiarity with… more
