- BrightSpring Health Services (Louisville, KY)
- …Plan (formerly Signature Advantage Plan) is seeking a detail-oriented and technically skilled Quality Medical Coder to support our clinical operations. The ... coding, data integrity, and working with healthcare systems. Responsibilities + The Quality Medical Coder is responsible for reviewing and assigning accurate… more
- Humana (Frankfort, KY)
- …AAPC CPC (no Apprentice) + Minimum of 3 years' experience as a Certified Medical Coder + Demonstrate ability to problem-solve complex coding issues + Experience ... 5 or more years of experience as a Certified Medical Coder + CPMA certification + MS-DRG...need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families,… more
- Cognizant (Frankfort, KY)
- **Job Title: Emergency Room Medical Coder - Level 1 Trauma Center (Remote)** **Company:** Cognizant Technology Solutions **Location:** Remote (Flexible Hours, ... for coding assignments + Perform peer reviews of coding work to maintain quality standards + Complete reports and maintain coding accuracy of **98% or higher**… more
- Datavant (Frankfort, KY)
- …to realize our bold vision for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses using ... Review, analyze, and code diagnostic information in a patient's medical record based on client specific guidelines for the...on client specific guidelines for the project. + The coder will ensure compliance with established ICD-10 CM, third… more
- Datavant (Frankfort, KY)
- …for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to ... codes using ICD-10-CM and ICD-10-PCS codes + Accurately sequence and abstract medical codes from patient records, ensuring precision and adherence to documentation +… more
- Datavant (Frankfort, KY)
- …team by being their coder -buddy. + Conducts one on one with coders focused on quality improvement. + Assists in tracking coder KPI and quality metrics on ... attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a...for supporting the Coding Supervisors in monitoring coders in quality and efficiency, serving as a resource and facilitator… more
- CenterWell (Frankfort, KY)
- …lead strategic initiatives to enhance the efficiency, accuracy, and compliance of medical coding operations across the organization. This role is responsible for ... ideal candidate is a seasoned leader with deep expertise in medical coding, risk adjustment, and operational transformation. **Key Responsibilities** **Strategy:** +… more
- Humana (Frankfort, KY)
- **Become a 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 coding assignments. Analyzes, enters,… more
- Humana (Frankfort, KY)
- …The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and billing for services rendered is complete, compliant ... the appropriate courses of action. The Nurse Auditor 2 validates and interprets medical record documentation to ensure billing for services is complete, accurate and… more
- Humana (Frankfort, KY)
- …CPC (Certified Professional Coder ) Certification + 2 or more years of medical record review knowledge + Familiar with coding guidelines (ie ICD-9/ICD-10) + Live ... and reporting and provides educational sessions with providers aimed at quality of care, documentation and coding improvements. + Collaboration with relationship… more
- Datavant (Frankfort, KY)
- …in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding education, interim coding ... and existing coders. **You Will:** + Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and appropriate coding references for accurate DRG… more
- CenterWell (Frankfort, KY)
- …us put health first** The Program Management Lead, Offshore Coding Operations conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes ... develop strategies for continuous improvement of offshore coding processes and quality . + Post-Visit/Offshore Coding Collaboration: + Partner with analytics to… more
- Molina Healthcare (Louisville, KY)
- …suite/applicable software program(s) proficiency. **Preferred Qualifications** * Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), ... of care provided to members. Contributes to overarching strategy to provide quality and cost-effective member care. Candidates with UM and Appeals experience are… more
- Molina Healthcare (Louisville, KY)
- …suite/applicable software program(s) proficiency. **Preferred Qualifications** + Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), ... The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for overseeing delegated activities to ensure… more
- Elevance Health (Louisville, KY)
- …Related Group Clinical Validation Auditor** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs ... you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of … more
- Datavant (Frankfort, KY)
- …realize our bold vision for healthcare. The individual will provide superior quality by performing audits pertaining to risk adjustment coding efforts. The ... Management to implement benchmarks, establish acceptable thresholds, and effective quality assurance programs. **You will:** + Maintain a ...of study preferred or 3-5 years related work experience coder with a minimum of 5 year's coding experience… more
- Datavant (Frankfort, KY)
- …is an opportunity to make a significant impact in the field of medical coding. You will provide essential consulting services and educational support, guiding ... a unique opportunity to play a pivotal role in elevating coding quality , ensuring compliance, and optimizing service outcomes in both hospitals and alternative… more
- Molina Healthcare (Louisville, KY)
- …accurate billing and coding. This role also works with the Health Plan Risk/ Quality leaders to strategically plan for supplemental data source (SDS) acquisition from ... providers as well as Electronic Medical Record (EMR) access. This position oversees management of...aligned with effective practices as identified in the healthcare quality improvement literature and within Molina plans. + Develops… more
- Highmark Health (Frankfort, KY)
- …Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** + Demonstrated ability to solve ... coding criteria, as well as other approved guidelines, payment and medical policies.Promote quality and efficiency in the delivery of review services. + Respect… more
- Datavant (Frankfort, KY)
- …instrumental in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding education, and coding ... Will Do:** + Performs Outpatient Facility coding audits of medical records and abstracts using ICD-10-CM, CPT, HCPCS, and...to ensure departmental workflow and case resolution + Provides coder education via the auditing process + Function in… more