- Guidehouse (Raleigh, NC)
- …remote **What You Will Do** **:** + Under the direction of the Director of Revenue Integrity, the Revenue Integrity Coding Billing Specialistprovides revenue ... **Job Family** **:** General Coding **Travel Required** **:** None **Clearance Required** **:**...claim level edits as assigned + As needed, review clinical documentation and diagnostic results as appropriate to validate… more
- ThermoFisher Scientific (Greenville, NC)
- …of all contracted services. **Discover Impactful Work:** The Associate /Medical Director provides medical oversight of clinical trials to ensure company ... colleagues manage the safety profile of new drugs in clinical trials, oversee case-processing activities through all phases of...meet the requirements of the role. Job leveling at Associate Medical Director or Medical Director… more
- Humana (Raleigh, NC)
- …these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical … more
- Humana (Raleigh, NC)
- …may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, dispute, grievance, and appeals processes, ... Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care received by… more
- Humana (Raleigh, NC)
- …discussions with an external provider. Some roles include an overview of coding practices and clinical documentation, dispute/grievance and appeals processes, ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Datavant (Raleigh, NC)
- …will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, ... HCC is a plus. **You Will:** + Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and...results for review by the facility or CCS HIM director . + Review disagreements on APC/DRG changes with the… more
- BayCare Health System (Raleigh, NC)
- …+ **Days:** Sunday - Thursday OR Tuesday - Saturday The Advanced Inpatient Coding Specialist is a PRN (non-benefit eligible) remote position. Responsibilities: + The ... Medical Records Advanced Inpatient Coding Specialist analyzes the multi day, multi-specialty complex documentation...monitors bill hold reports. Serves as a liaison to Clinical Documentation Specialist Team and Quality Department for ICD-10… more
- BayCare Health System (Raleigh, NC)
- …to 3:30 PM + **Days:** Monday through Friday The Advanced Inpatient Coding Specialist is a full-time remote position. _Sign on bonuses available!_ Responsibilities: ... + The Medical Records Advanced Inpatient Coding Specialist analyzes the multi day, multi-specialty complex documentation...monitors bill hold reports. Serves as a liaison to Clinical Documentation Specialist Team and Quality Department for ICD-10… more
- BayCare Health System (Raleigh, NC)
- …encounters to accurately assign diagnosis and procedural codes-using ICD-10-CM and CPT-4 coding systems. + Works in conjunction with various departments for missing ... Strong utilization of medical terminology and anatomy. + Assists Manager/ Director with mentoring/training of Coder I and Coder II...of Coder I and Coder II team members and clinical practice students from various colleges. + Performs other… more
- CenterWell (Greenville, NC)
- …calls from the field staff and assisting with weekly case conferences. Refers clinical questions to Branch Director as necessary. + Maintains the client ... productivity / geographic issues and forwards schedule to Branch Director for approval prior to distribution to staff. +...internal transfer of patients between branch offices. + If clinical , receives lab reports and assesses for normality, fax… more