- 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
- Intermountain Health (Murray, UT)
- …Medical Billing + Medical Terminology + Claims Analysis + Healthcare Common Procedure Coding System (HCPCS) **Minimum Qualifications** + Medical ... revenue cycle by performing final validation and resolving professional claims issues that do not require coding ...professional claims issues that do not require coding expertise. Key responsibilities include manual charge entry and… more
- Geisinger (Danville, PA)
- …management, physicians, clinical and non-clinical personnel utilizing the national correct coding standards, approaches, and industry standard coding rules to ... Biller through AAPC + Applies expanded knowledge of CPT, ICD-10 and HCPCS coding skills toward the maintenance and development of prospective claim edits and… 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
- 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
- HCA Healthcare (Ocala, FL)
- **Description** **Introduction** Do you have the career opportunities as a Clinical Denial Coding Review Specialist you want with your current employer? We have an ... which is part of the nation's leading provider of healthcare services, HCA Healthcare . **Benefits** Parallon offers...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- HCA Healthcare (Nashville, TN)
- …more than 1,300 physician practices and 170+ urgent care centers. We are HCA Healthcare 's graduate medical education leader. We provide direction for over 260 ... Are you passionate about the patient experience? At HCA Healthcare , we are committed to caring for patients with...We care like family! Jump-start your career as a Claims Operations Lead today with Work from Home. **Benefits**… 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
- 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
- HCA Healthcare (Richmond, VA)
- **Description** **Introduction** Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career ... individual is recognized. Submit your application for the opportunity below: Outpatient Coding Resolution Specialist Parallon **This is a work from home position!**… more
- HCA Healthcare (San Antonio, TX)
- …in Company and HSC policy + Reviews all official data quality standards, coding guidelines, Company policies and procedures and clinical/ medical resources to ... Do you want to join an organization that invests in you as a Coding Account Resolution Specialist-Inpatient? At Parallon, you come first. HCA Healthcare has… more
- Genesis Healthcare (PA)
- …Care Organization (ACO) team. This is a remote position. **Current certification in medical coding from an accredited institution (such as AAPC or AHIMA) ... assisting with the LTC ACO HCC program ensuring that claims are coded and documented accurately and completely, helping...medical documentation and the ensuing billing documentation and coding ; + Work with team to develop comprehensive ICD-10… 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
- University of Southern California (Alhambra, CA)
- …Coding Denials Management Specialist" analyze, investigate, mitigate, and resolve all coding -related ' claims denials' and ' claims rejections,' specific to ... services provided to covered patients. Manages the denial management process for coding -related denials, triage denied claims to distinguish coding -related… 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
- 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
- Humana (Columbus, OH)
- …of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle ... community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from...one of these qualifications for 4 years) * MS-DRG coding /auditing experience * Experience reading and interpreting claims… more
- Elevance Health (Chicago, IL)
- …spending. The **DRG Coding Auditor Principal** is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) ... audits claims by integrating advanced or convoluted medical chart coding principles (found in the...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- Aston Carter (Salem, OR)
- …in initiating and leading performance improvement projects within a medical coding environment. + Understanding of EHR, Claims Adjudication Systems, Revenue ... Job Title: Medical Coding Analyst Job Description The...use of data analysis tools. + In-depth understanding of claims processing, clinical edits, fee schedules, and payer contracts.… more
- Guidehouse (Lewisville, TX)
- …or customer service. + Working knowledge can be of the following: insurance claims , billing, coding , follow-up, finance, accounting or customer service related ... **:** None **What You Will Do:** The **Credit Balance Specialist** **(Physician Claims )** will manage credit balance workloads and respond and follow-up on external… more