- CDPHP (Albany, NY)
- …these values and invites you to be a part of that experience. The Clinical Review and Coding Nurse is responsible to attain procedure and diagnosis ... and consistency on referred cases. The RN will perform and coordinate the clinical component of the provider appeal function including communication of the decision… more
- R1 RCM (Boise, ID)
- …automation, and workflow orchestration. As our ** Clinical Coding Appeals Nurse ** , you will help review and interpret medical records to draft ... position. **Here's what you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical records to appeal denied and… more
- BrightSpring Health Services (Louisville, KY)
- Our Company BrightSpring Health Services Overview The Clinical Coding and Audit Specialist monitors, responds and performs the clinical coding and audit ... needed with appropriate staff and/or department for correction + Review coding to ensure documentation is completed...timely, compliant documentation that drives accurate billing Qualifications + Clinical review positions will require a RN… more
- Northwell Health (Garden City, NY)
- …Seeking RN - BSN candidates with a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist- Clinical . Conducts Home Health ... standards are maintained in compliance with Federal and State regulations. + Applies coding rules and regulations to the validation review process. + Reviews… more
- Virtua Health (Marlton, NJ)
- …Coding Audit Response: Conducts Trains new coders to utilize the medical record, clinical , coding and abstracting systems, in conjunction with UHDDS and other ... TIN by creating audit samples, communicating results to clinicians and providing annual coding education. Performing chart audits to review CPT, ICD-10- CM and… more
- UNC Health Care (Chapel Hill, NC)
- …we serve. Summary: This positon trains and audits Inpatient and Outpatient Clinical Documentation Specialists (CDS) across all HCS entities that are owned or ... shared services. This position reports to the HCS Supervisor Coding and CDI Quality and Training. This position may...across the state to train and shadow round with Clinical Documentation Specialists. The CDS auditor provides elbow to… more
- Hackensack Meridian Health (Hackensack, NJ)
- …diagnosis and the impact on severity of illness and Risk of Mortality. + Provides clinical expertise and references to the coding staff as needed. + Utilizes ... Office and Google Suite platforms. **Licenses and Certifications Required:** + Certified Coding Specialist. + NJ State Professional Registered Nurse License.… more
- Northwell Health (Lake Success, NY)
- …standards are maintained in compliance with Federal and State regulations. + Applies coding rules and regulations to the validation review process. + Reviews ... substantiated by the documentation in the Medical Record. Job Responsibility + Leverages clinical expertise to identify and validate DRG code assignment + Full … more
- UPMC (Harrisburg, PA)
- …payers. Interact with physicians regarding clarifications necessary for appropriate coding and clinical documentation standards. **Responsibilities:** + Adhere ... This CDI Coding Lead is a hybrid opportunity that oversees...necessary hospital groups/departments. Ensure accuracy and timely input of clinical documentation to support severity of illness and risk… more
- Froedtert South (Kenosha, WI)
- Registered Nurse Clinical Documentation Specialist Froedtert South Kenosha, WI (Onsite) Full-Time Apply on company site Job Details + POSITION PURPOSE + Performs ... concurrent clinical documentation review to promote complete capture...concentrated focus. + Educates patient care team members regarding clinical documentation requirements and coding guidelines and… more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of the Utilization Review Team and ... reviewing claims disputes and retrospective requests for services requiring clinical review prior to payment. The Utilization... review prior to payment. The Utilization Review Nurse will use appropriate governmental policies… more
- Northwell Health (Riverhead, NY)
- …documentation ensuring accuracy and integrity in the medical record. 2.Facilitates appropriate clinical documentation to support diagnosis coding and ensure the ... documentation requirements and provides timely and accurate responses to clinical documentation and coding questions. 8.Demonstrates knowledge of ICD-10… more
- Fresenius Medical Center (Philadelphia, PA)
- …and auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding . + Manages clinic ... Summary Develops operating budgets and standards of performance and ensures clinical department operates within budget and in accordance with performance standards.… more
- Fresenius Medical Center (Newport News, VA)
- …or federal surveys. + Participates in the completion of the FMS Administrative Clinical Review . **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical ... **POSITION FEATURES:** up to $15,000 SIGN ON BONUS!! Clinical Manager - Outpatient Dialysis Position will require...+ Accountable for completion of the Annual Standing Order Review and ICD coding . + Checks correspondence… more
- CDPHP (Albany, NY)
- …The Utilization Review (UR) Nurse is responsible for the clinical review and documentation for services requiring prior authorization. This includes ... reviews for acute and subacute rehabilitation, transportation and DME requests. Review of identified high-cost admissions and extended stays and inpatient… more
- United Health Services (Johnson City, NY)
- LPN Medical Review Nurse , UHS Home Care TTHH United Health Services is seeking a LPN Medical Review Nurse to join our Quality Management 07 department at ... will be provided for OASIS documentation and for ICD-10 coding certification. We prefer familiarity with required clinical...and current registration to practice as a licensed practical nurse in New York State. Preferred: + Not Applicable.… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …to appropriate guidelines. This position requires strong clinical and medical coding skills to review claims for medical necessity, appropriate coding ... RoleThe Claims Nurse Reviewer is responsible for reviewing claims, validating coding and medical necessity of the services submitted and pricing the claims… more
- SSM Health (MO)
- …as well as the level of services rendered. The CDI Specialist assesses clinical documentation through extensive review of the medical record, interaction with ... is complete and accurate. **Principal Duties and Responsibilities** Facilitates appropriate clinical documentation to support appropriate diagnosis coding and to… more
- UTMB Health (Galveston, TX)
- … Coding Specialist (CCS) certification, and a minimum of 3 years medical coding experience. **Or** . Registered nurse (or medical school graduate) with a ... interaction with physicians, members of the patient care team, and hospital coding staff. **Function:** Ensures clinical documentation accurately reflects the… more
- STG International (Macon, GA)
- …understood by the team member. + Assist the Director of Nursing in planning clinical supervision for nurse aide trainees, nursing students and newly hired ... STGi is seeking a Licensed Practical Nurse /Licensed Vocational Nurse to provide services...facility policies; document census as established for billing and clinical purposes. + Assist with safe and orderly resident… more