• Medical Director - National Medicare

    Humana (Columbus, OH)
    …clinical reference materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage ... clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed… more
    Humana (04/24/25)
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  • Medicare Compliance Specialist

    Sedgwick (Atlanta, GA)
    …**:** To coordinate, analyze and facilitate Medicare Compliance and Medicare Set-Aside (MSA) functions within the assigned team . **ESSENTIAL FUNCTIONS ... reviews and analyzes claim files and/or management reports. + Compiles and organizes medical records; distributes to Medicare Compliance nurses for analysis; and… more
    Sedgwick (05/01/25)
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  • Technical Business Analyst - Aetna Medicare

    CVS Health (Tallahassee, FL)
    …Tools & Technology is seeking a Technical Business Analyst to join our exciting team . We build and support internal Medicare related applications that allow our ... innovative ideas, define the requirements, and recommend actionable next steps. The team is looking for a self-driven individual with very strong business analysis… more
    CVS Health (04/27/25)
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  • Accounting Clerk- Patient Financial Services…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Accounting Clerk- Patient Financial Services ( Medicare & Medicaid Claims Follow-Up)-Corporate 150 East 42nd Street - Full-Time Days** Under the ... (oral and written) + The ability to work independently and on a team + Knowledgeable with the Patient Accounts System(s): Eagle, MEMS, Trac/On-Trac, Cirius, FSS,… more
    Mount Sinai Health System (04/16/25)
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  • Medicare Billing and Collections Specialist

    PruittHealth (Norcross, GA)
    …responsibilities for all assigned locations. This position functions within a team environment and under general supervision. Successful individuals manage a volume ... skilled at problem solving and account resolution. They work well within a team and help foster an environment where continuous improvement in business processes and… more
    PruittHealth (04/18/25)
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  • Clinical Documentation Improvement…

    SUNY Upstate Medical University (Syracuse, NY)
    …clarification or optimization are identified, the CDI Specialist will collaborate with the medical team to clarify necessary items through a dedicated and ... Job Summary: The Clinical Documentation Improvement (CDI) Specialist primary responsibility is to...(CDI) Specialist primary responsibility is to ensure the inpatient medical record accurately supports severity of illness and risk… more
    SUNY Upstate Medical University (03/19/25)
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  • Clinical Documentation Review Specialist

    Robert Half Office Team (Rancho Cordova, CA)
    …in Rancho Cordova, California. This role involves a meticulous examination of hospital medical documentation , communication with medical staff, and ensuring ... reflecting the complexity and severity of patient care. Responsibilities: * Evaluate medical record documentation concurrently on the nursing units to guarantee… more
    Robert Half Office Team (04/11/25)
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  • Clinical Documentation Integrity Specialist…

    AdventHealth (Altamonte Springs, FL)
    …valid clarifications that are easily understood by physicians and other members of the medical team . . Accurately reconciles all cases in CDI Software. . Assists ... of the patient. The CDS educates members of the patient care team regarding documentation guidelines, including physicians, allied health practitioners, nursing,… more
    AdventHealth (03/12/25)
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  • Clinical Documentation Specialist, Second…

    SSM Health (MO)
    …care team member, an auditor, and an educator ensuring medical records are complete and clinical documentation comprehensively represents the ... or medical school, or Associate's degree and Certified Clinical Documentation Specialist (CCDS) certification from the Association of Clinical Documentation more
    SSM Health (03/19/25)
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  • RN Clinical Documentation Improvement…

    AdventHealth (Hinsdale, IL)
    …valid clarifications that are easily understood by physicians and other members of the medical team . * Accurately reconciles all cases in CDI database. * ... of the patient. The CDS educates members of the patient care team regarding documentation guidelines, including physicians, allied health practitioners, nursing,… more
    AdventHealth (05/01/25)
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  • Supv Clinical Documentation / HIM Clinical…

    Hartford HealthCare (Farmington, CT)
    documentation program. . Develop a collaborative and effective clinical documentation team . . Responsible for regional/facility accurate Case Mix Index ... patient care givers to ensure accurate and timely clinical documentation in the medical record. This role.... Provide necessary feedback and conflict resolution to clinical documentation team . Track program successes and… more
    Hartford HealthCare (04/01/25)
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  • Clinical Documentation Specialist

    Northwell Health (Lake Success, NY)
    …risk of mortality, and complexity of care provided. Responsible for concurrent inpatient medical record reviews for Medicare , Medicaid and all commercial payers. ... or conflicting documentation . Job Responsibility 1.Facilitates clarification of clinical documentation ensuring accuracy and integrity in the medical record.… more
    Northwell Health (04/14/25)
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  • Quality Clinical Documentation Improvement…

    Dignity Health (Rancho Cordova, CA)
    …performing a comprehensive review of ambulatory medical records to confirm documentation compliance with the Centers for Medicare and Medicaid Services (CMS) ... **Overview** Dignity Health Medical Foundation, established in 1993, is a California...of the QCDI RN position is to review provider documentation , provide education to providers, and review trends of… more
    Dignity Health (05/01/25)
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  • Clinical Documentation Specialist (RN)

    Saint Francis Health System (Muskogee, OK)
    …interaction with medical , nursing, and ancillary staff to capture clinical documentation at the point of care; and health information staff to assure appropriate ... for severity of illness and quality in the medical record. Key functions include extensive record review and...a complex nature based on training in the clinical documentation process. Active participation in team meetings… more
    Saint Francis Health System (04/06/25)
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  • RN Clinical Documentation Second Level…

    University of Washington (Seattle, WA)
    Req #: 244821 Department: UW MEDICAL CENTER - CLINICAL DOCUMENTATION Posting Date: 04/21/2025 Closing Info: Open Until Filled Salary: $10,000 - $13,800 per month ... Integrity Program (CDIP) performs concurrent review of inpatient medical records to ensure provider documentation accurately...participate in the education and evaluation of the CDI team . + Collaborate with medical records coding… more
    University of Washington (04/10/25)
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  • Clinical Documentation Integrity Specialist

    UCLA Health (Los Angeles, CA)
    …and mid-levels; and assisting with appropriate documentation strategies. Partnering with Medical Coding, Case Management and the Quality team , you will ... UCLA Health. You will become a member of our highly successful of our Documentation Improvement Integrity team , including all modalities. This will involve daily… more
    UCLA Health (03/18/25)
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  • Clinical Documentation Coding Specialist…

    University of Utah Health (Salt Lake City, UT)
    …EO/AA_ This position provides inpatient facility coding and Clinical Documentation Improvement (CDI) support in Health Information Management department with ... coding guidelines established by DNV, the American Hospital Coding Association, and Medicare /Medicaid, etc. Corporate Overview: The University of Utah is a Level 1… more
    University of Utah Health (04/07/25)
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  • Insurance Coordinator

    Fresenius Medical Center (Fresno, CA)
    …options: + Educates on the availability of alternative insurance options (ie, Medicare , Medicaid, Medicare Supplement, State Renal programs and COBRA). + ... + Discusses insurance options when insurance contracts are terminated. Responsibilities involving Medicare and Medicaid include but are not limited to: + Determining… more
    Fresenius Medical Center (04/24/25)
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  • Sr Clinical Operations Compliance Specialist-MA

    Medical Mutual of Ohio (OH)
    …including the ability to make presentations. . Intermediate to advanced Microsoft Office skills. Medical Mutual is looking to grow our team ! We truly value and ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans....places in and around town, just for being a Medical Mutual team member. + The opportunity… more
    Medical Mutual of Ohio (04/15/25)
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  • Medical Specialist 1

    New York State Civil Service (Queens Village, NY)
    …as needed to facilitate medical follow-up after discharge.* Maintains medical documentation consistent with agency, State and Federal requirements.* ... HELP Yes Agency People With Developmental Disabilities, Office for Title Medical Specialist 1 Occupational Category Health Care, Human/Social Services Salary Grade… more
    New York State Civil Service (04/11/25)
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