- Sharp HealthCare (San Diego, CA)
- …and corrective actions, if necessary.Reviews the electronic health record to identify potential coding and billing compliance issues. Prepares written ... and assess Sharp's potential risks using SHC's billing and coding claims data, risk assessment...and Procedure maintenanceWorks in collaboration with the Director and Manager of Compliance and System Management (HIM, CDI, Case… more
- Elevance Health (Los Angeles, CA)
- …/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology strongly preferred. For ... **DRG Coding Auditor Principal** **_Virtual: _** _ _ This...level auditors. + Identifies new claim types by identifying potential claims outside of the concept where additional recoveries… more
- Rady Children's Hospital San Diego (San Diego, CA)
- JOB SUMMARY: Under the direction of the Manager , Professional Billing & Coding , the Billing & Collections Rep I is responsible to review and process ... and CCI edits flagging the charges routing to the billing system. They are expected to make updates and...to validate and accurately complete the claims identified with potential new payor plan coverage added to the patient's… more
- J&J Family of Companies (Orange, CA)
- …expertise with both pharmacy and medical/buy & bill benefits (as applicable), coding , and billing . + Reimbursement or relevant managed care experience ... state experience + Advanced degree and/or relevant certifications in prior authorization and/or billing and coding + Strong market access acumen as it relates… more
- Stanford Health Care (Palo Alto, CA)
- …Stanford Health Care job.** **A Brief Overview** The Revenue Integrity Program Manager is a critical role responsible for optimizing hospital and professional ... revenue, identifying potential revenue leakage while ensuring compliance in charging and billing practices within the healthcare system. Serving as the primary… more
- Elevance Health (Walnut Creek, CA)
- …accuracy and quality standards as established by audit management. + Identifies potential documentation and coding errors by recognizing aberrant coding ... medical claims billing and payment systems, provider billing guidelines, payer reimbursement policies, and coding ...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Stanford Health Care (Palo Alto, CA)
- …of treatment records. + Displays a thorough understanding of radiation oncology billing and coding . Reviews treatment/ simulation documentation and billing ... effectively and efficiently using lean methodologies. Communicates appropriate issues to Operations Manager for proper handling and potential escalation. Acts as… more
- Sharp HealthCare (Chula Vista, CA)
- …Centricity Insurance Verification (IF). If patient unable to provide insurance, search for potential coverage through MCA for SRS/SCMG and MPV (or Portal) for ... potential Medicare or Medi-Cal.Use Coordination of Benefits (COB) standards...or Medi-Cal.Use Coordination of Benefits (COB) standards to prioritize billing order of insurance plans.Medicare patients - Medicare Secondary… more
- Stanford Health Care (San Jose, CA)
- …of treatment records. + Displays a thorough understanding of radiation oncology billing and coding . Reviews treatment/ simulation documentation and billing ... from prescribed treatment delivery and reports all deviations to the Operations Manager . + Uses C*I*CARE principles and techniques to provide explanations for… more
- Sharp HealthCare (Santee, CA)
- …information (contrast, fluoroscopy, QC, resource, technical modifiers, billing modifiers, coding of exam, technologist/student/RN/Radiologist).Complete ... weekends. **What You Will Do** Under the direction of the Manager /Supervisor/Ops Coordinator is responsible for directing day-to-day activities of the department;… more