- Catholic Health Initiatives (Omaha, NE)
- …+ Document medical findings, diagnoses, and treatment plans. + Ensure compliance with coding and billing regulations. + Diagnostic Procedures: + Order and ... interpret diagnostic tests, such as lab work and imaging. + Perform procedures as needed + Collaborate with specialists for further diagnostic evaluation. + Team Collaboration: + Collaborate with nurses, specialists, and other healthcare professionals. +… more
- Catholic Health Initiatives (Omaha, NE)
- …approach. + Documentation: Maintain accurate patient records and ensure compliance with coding and billing regulations. + Team Collaboration: Work with ... healthcare professionals and participate in interdisciplinary meetings. + Quality Improvement: Engage in quality assurance initiatives and analyze clinical outcomes for improvement. + Compliance: Adhere to ethical standards and stay informed about healthcare… more
- Catholic Health Initiatives (Omaha, NE)
- …+ Document medical findings, diagnoses, and treatment plans. + Ensure compliance with coding and billing regulations. + Diagnostic Procedures: + Order and ... interpret diagnostic tests, such as lab work and imaging. + Perform procedures as needed + Collaborate with specialists for further diagnostic evaluation. + Team Collaboration: + Collaborate with nurses, specialists, and other healthcare professionals. +… more
- CVS Health (Lincoln, NE)
- …(CPC) will perform medical claim reviews to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation ... The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical...and company requirements are met and recognize any concerning billing patterns or trends. Activities include: - Conduct a… more
- Molina Healthcare (NE)
- …and state specific policies and regulations in order to identify incorrect coding , abuse and fraudulent billing practices, waste, overpayments, and processing ... errors of claims. ( _Use for claims specific positions only_ ) * Prepares, tracks and provides audit findings reports according to designated timelines * Presents audit findings and makes recommendations to management for improvements based on audit results.… more
- Catholic Health Initiatives (Omaha, NE)
- …payers to address and resolve outstanding insurance balances related to coding denials in accordance with established standards, guidelines and requirements. The ... specific requirements. + Review patient medical record to compare documentation and coding ; change coding based on documentation to include diagnosis codes,… more
- Humana (Lincoln, NE)
- …audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support ... and interprets medical documentation to ensure capture of all relevant coding . Identifies members with high-risk CMS Hierarchical Condition Categories (HCC) and… more
- Cardinal Health (Lincoln, NE)
- …for denial or reduced payment. + Document all collection activities in the billing system according to departmental procedures. + Follow up on unpaid claims within ... payer-specific guidelines and timelines. + Coordinate with other billing team members, coders, and providers to resolve claim discrepancies. + Maintain up-to-date… more
- Humana (Lincoln, NE)
- …clinical audit/validation processes to ensure that medical record documentation and billing for services rendered is complete, compliant and accurate to support ... Nurse Auditor 2 validates and interprets medical record documentation to ensure billing for services is complete, accurate and follows all necessary guidelines.… more
- Cardinal Health (Lincoln, NE)
- …getting the right things done. **_Responsibilities_** + Submitting medical documentation/ billing data to insurance providers + Researching and appealing denied ... and rejected claims + Preparing, reviewing, and transmitting claims using billing software including electronic and paper claim processing + Following up on unpaid… more