- HCA Healthcare (Nashville, TN)
- …worth of each individual is recognized. Submit your application for the opportunity below: Clinical Denials Coding Review SpecialistParallon **Benefits** ... **_Note: Eligibility for benefits may vary by location._** We are seeking a Clinical Denials Coding Review Specialist for our team to ensure… more
- Fairview Health Services (St. Paul, MN)
- **Job Overview** The Outpatient Coding Denials Specialist performs appropriate efforts to ensure receipt of expected reimbursement for services provided by the ... to billing, coding , and documentation. The Outpatient Coding Denials Specialist will also handle audit-related...denial reports and other statistical reports. + Collaborates with Clinical Denials Nurse Specialist and Leadership in… more
- Kaleida Health (Buffalo, NY)
- **Director Clinical and DRG Denials ** **Location:** Larkin Bldg @ Exchange Street Location of Job: US:NY:Buffalo Work Type: Full-Time **Shift:** Shift 1 Job ... Description **Summary:** The Director, Clinical & DRG Denials provides ...managed care practices including but not limited to: utilization review , RAC, MAC, Q10, clinical and DRG… more
- St. Luke's University Health Network (Allentown, PA)
- …and tracks outcomes regarding appeal process. Assists billing staff regarding outpatient denials for experimental, coding or other issues that may require ... clinically appropriate. + Investigates managed care and commercial insurance rejections, denials for possible experimental services and coding issues, providing… more
- BAYADA Home Health Care (Orlando, FL)
- …BAYADA Home Health Care has an immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work remotely. ... match, direct deposit, and employee assistance program **Responsibilities:** + Review clinical information for appropriateness, congruency, and...MCM. + Prevent or decrease the occasion of Medicare denials by assuring proper coding on the… more
- BAYADA Home Health Care (Orlando, FL)
- …a full time OASIS Review and Coding Manager. The OASIS and Coding Review Manager provides support to all BAYADA Home Health Care Medicare service offices ... about BAYADA Benefits, click here (https://www.bayada.com/benefits/) . **Responsibilities:** + Review clinical information for appropriateness, congruency, and… more
- Children's Hospital Boston (Boston, MA)
- …compliance and Share Service Center - Coding and billing to manage clinical validation denials . + Collaborating on appeal processes and assessing trends to ... preferred. + 2 years of clinical chart review experience applying ICD coding knowledge to medical record review Office/Site Location:BostonRegular,… more
- Independent Health (Buffalo, NY)
- …benefits and a culture that fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist-Senior will be responsible for reviewing ... coding and clinical decisions on cases involving complex clinical ...guidelines and financial policies/contracts. + Responsible for all reconsideration clinical appeals to include review of records,… more
- Western Washington University (Bellingham, WA)
- …for compliance and any legal updates or other considerations. + Reviews claims denials and rejections pertaining to coding and medical necessity issues, and ... revenue. + Analyzes and resolves complex billing related claim denials in a manner that ensures accurate and optimal...in response to newly implemented workflows or laws/regulations. + Review spreadsheets for coding compliance to ensure… more
- Banner Health (AZ)
- …Reviews medical records. Performs an audit of clinical documentation to ensure that clinical coding is accurate for proper reimbursement and that coding ... diagnostic and procedure code assignments. Collaborates on DRG and coding denials , billing edits/rejections to provide ...to understand the Medicare Prospective Payment System, and the clinical coding data base and indices, and… more
- Omaha Children's Hospital (Omaha, NE)
- …and assigning valid CPT, ICD10, and HCPCS codes for complex surgical cases, and/or coding verification and review to ensure coding accuracy and appropriate ... to regulation (eg, ICD10CM, CPT, HCPCS, UHDDS, and HIPPA coding guidelines) and/or abstract accurate clinical information...accuracy of billing. * Trends identified from documentation and denials . * Provide input timely responses to coding… more
- St. Luke's University Health Network (Allentown, PA)
- …who ensures clean claim submission and timely review and resolution of coding related claim denials for professional services, FQHC, MSO, and ASCs across ... coding , compliance, and documentation guidelines + Resolve Charge Review and Claim Edit CCI/LCD edits, diagnosis coding...and MUE frequency for clean claim submission + Resolve coding denials through claim correction or appeal.… more
- Rush University Medical Center (Chicago, IL)
- …utilization. Provide feedback and focused educational programs on the results of auditing, review claim denials pertaining to coding , and implement ... EMR charge capture support. 7. Serves as a liaison point of contact for clinical coding inquiries and communication for professional billing revenue cycle 8.… more
- Kaleida Health (Buffalo, NY)
- …The CQC acts as an essential resource working collaboratively with Coding Specialists, Physicians/Providers, Clinical Document Specialists, Quality Department, ... Corporate Compliance, Clinics, and Ancillary depts to perform and review the coding and DRG assignment for...DRG assignment for accuracy. Serves as the liaison between coding specialists and clinical documentation specialists for… more
- Billings Clinic (Billings, MT)
- … coding . Analyzes and reports coding distribution and trends in clinical denials to providers and management. Analyzes payer bulletins and regulations and ... sessions on the full circle of proper revenue cycle practices regarding clinical documentation, coding , reimbursement, denials and appeals. Strives… more
- Atlantic Health System (Morristown, NJ)
- Responsible for coding quality audits of all records (outpatient, inpatient, procedures, testing) to assure appropriateness and accurate code assignments in ... for the providers and staff; also responsible for assisting with coding inquiries from providers, charge posters, billing staff, etc. Principal Accountabilities:… more
- St. Luke's University Health Network (Allentown, PA)
- …draft appeal letters, including supporting clinical documentation from record, supporting clinical evidence, and the coding argument, to support network ... Coding and CDMP Managers for education of the medical staff, clinical documentation professionals and the coding professionals on documentation issues that… more
- Mohawk Valley Health System (Utica, NY)
- …coders to ensure accurate code assignment and provide feedback for improvement. + Review coding practices against payer-specific rules and regulations to ensure ... Coding Auditor and Educator is responsible for auditing clinical documentation and coding practices to ensure...medical coder, with at least 1 year in a coding review or educator role. + In-depth… more
- Weill Cornell Medical College (New York, NY)
- …EPIC work queues to ensure claims are being coded appropriately. + Performs coding and documentation review prior to charge entry for physician services. ... errors and works to reduce claim edits and denials . Identifies compliant coding opportunities to increase...invoice based on department policies and guidelines. Resolves charge review work queue edits relating to coding .… more
- Hartford HealthCare (Farmington, CT)
- …1. Analyze and resolve specific billing edits and denials that require coding and billing expertise with some clinical knowledge that are delaying claims ... modifiers, diagnosis codes as appropriate including charge corrections 2. Identify charging, coding , or clinical documentation issues and work with appropriate… more