- Humana (Bismarck, ND)
- …scenarios arise from outpatient , inpatient or post-acute care environments. The Medical Director will have discussions with external physicians by phone to ... caring community and help us put health first** The Medical Director relies on medical ...work is assisted by diverse resources, which may include national clinical guidelines, state policies, CMS policies and determinations,… more
- CenterWell (Bismarck, ND)
- …processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, ... caring community and help us put health first** The Medical Director , Primary Care relies on ...work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference… more
- Humana (Bismarck, ND)
- …processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, ... caring community and help us put health first** The Medical Director relies on medical ...work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference… more
- Humana (Bismarck, ND)
- …processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, ... caring community and help us put health first** The Medical Director actively uses their medical...work is assisted by diverse resources, which may include national clinical guidelines, CMS and state policies and determinations,… more
- Cardinal Health (Bismarck, ND)
- …of documentation and coding related to physician or hospital (inpatient and outpatient ) billing and/or medical necessity reviews. + Prepares written reports ... and compliance issues. **Compliance Audit Manager** Reporting to the Compliance Director , this position supervises and manages compliance audits to determine… more
- Catholic Health Initiatives (Bismarck, ND)
- …Mobridge, SD CHI St. Alexius Health offers a comprehensive line of inpatient and outpatient medical services, including: a Level II Trauma Center, primary and ... by the patient care staff. 2. Participates in all National Patient Safety Goals as they apply to patient...items in need of repair to supervisor, manager or director . 5. Receives, prioritizes and responds to incoming calls… more
- Cognizant (Bismarck, ND)
- …. Draft and submit the medical necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with ... the Health Plan/Payer. The comprehensive process includes analyzing, reviewing, and processing medical necessity denials for resolution. You will be a valued member… more
- Datavant (Bismarck, ND)
- …and existing coders. **You Will:** + Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and appropriate coding references for accurate DRG ... results for review by the facility or CCS HIM director . + Review disagreements on APC/DRG changes with the...trauma centers + Experience coding and auditing inpatient and outpatient records for various facilities + Track record of… more