- Dignity Health (Bakersfield, CA)
- …for ensuring the integrity of the adverse determination processes and accuracy of clinical decision making, as it relates to the application of criteria and ... specific to member's condition and request. - Provides relevant clinical information to the request and the criteria used...modify as appropriate. - Knowledge of ICD-10, CPT, HCPCS coding , medical terminology and insurance benefits. - Knowledge of… more
- Elevance Health (CA)
- …ensuring appropriate, consistent administration of plan benefits by reviewing clinical information and assessing medical necessity under relevant guidelines and/or ... the medical management processes. + Assesses and applies medical policies and clinical guidelines within scope of licensure. + These reviews may require in-depth… more
- Emanate Health (West Covina, CA)
- … coding guidelines. Reviews documentation for accurate abstracting of clinical data to meet regulatory and compliance requirements. **Job Requirements** **Minimum ... and Physiology. Computer experience required. **Minimum Experience Requirement:** One year coding experience using ICD-10 CM/PCS and CPT required. Knowledge of… more
- Datavant (Sacramento, CA)
- …and reimbursement purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity and severity of ... by coders and or auditors + Participate in weekly coding project review meetings + Any other tasks asked...**What You Need to Succeed:** + 2 years' HCC Coding experience + 2 years' HCC Auditing experience +… more
- Datavant (Sacramento, CA)
- …and reimbursement purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity and severity of ... guidelines. + Coders must meet and maintain a 95% coding accuracy rate. + Any other task requested by...or CRC). + A minimum of 2 years HCC coding experience, while certified. + Full understanding and knowledge… more
- Sutter Health (San Francisco, CA)
- …numbers in medical record/computer as directed. + Collects pertinent demographics and clinical data for each authorization required and places calls to insurance ... KNOWLEDGE:** Medical terminology, Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS)/International Classification of Diseases (ICD)-9 coding… more
- Tiburcio Vasquez Health Center (San Leandro, CA)
- …must incorporate standard medical practices and health center policies into their clinical practice to provide quality care commensurate with training and licensure. ... and initiation of life-saving procedures in emergencies. + Provides various clinical oversight of NP/PA trainees, NP residents, and/or new providers. Directs… more
- Tiburcio Vasquez Health Center (Hayward, CA)
- …and initiation of life-saving procedures in emergencies. + Provides various clinical oversight of NP/PA trainees, NP residents, and/or new providers. Directs ... to; completion of medical records and documentation management of Inbox and results, coding , and signing off charts within the designated time set by the… more
- Insight Global (Orange, CA)
- …this role will serve as a critical bridge between our clinical stakeholders, analysts, and engineersdeveloping advanced analytics solutions that impact patient ... in analytics engineering and data storytelling, and foster deep partnerships with clinical and operational leaders. Your work will contribute to a culture of… more
- Stanford Health Care (Palo Alto, CA)
- …special departmental tasks such as EKG, ear lavage, etc. + Clinical Administration: Handle check-in/out, virtual rooming for providers, vaccine administration, ... use and apply medical terminology in performing his/her duties. + Knowledge of coding and billing regulations. + Knowledge of computer systems and software used in… more