- Excellus BlueCross BlueShield (Rochester, NY)
- …Essential Accountabilities: Level I + Performs pre-service, concurrent and post-service clinical reviews to determine the appropriateness of services requested for ... and treatment of members' medical health conditions, applying established clinical review criteria, guidelines and medical policies and contractual benefits… more
- Catholic Health (Buffalo, NY)
- …+ Patient Access + Health Information Management + Coding and Coding Education + Inpatient, Outpatient and Ambulatory Clinical Documentation Integrity + ... Health. This role also has secondary oversight for inpatient clinical denials, Utilization Management and vendor performance of Healthcare...requirements for the Medical Record + Knowledge of ICD coding , working knowledge of coding for third… more
- Mount Sinai Health System (New York, NY)
- …registration, coding , and billing accuracy and performance. * Support clinical leaders and administrators by providing education on revenue cycle best practices ... optimizing processes across the entire revenue cycle-including registration, pre-authorization, coding , billing, collections, reimbursement, and financial analysis-to drive revenue… more
- UHS (Norwich, NY)
- …Office to refine and monitor billing. Acts as a resource to physicians, clinical staff and business office staff regarding coding questions; provides regular ... standards based on patient care needs, patient flow, procedures and other clinical needs; interviewing, selecting and hiring new employees; ensuring compliance with… more
- Mount Sinai Health System (New York, NY)
- …ensures consistent supply charging practices across departments and facilities, compliance with clinical research and free device set-ups, and the review of device ... + Performs Charge Capture in daily activities related to coding and billing for all supplies and implants purchased...and billing for all supplies and implants purchased by clinical departments. + Reviews Clinical Research documentation… more
- Datavant (Albany, NY)
- …realize our bold vision for healthcare. **What We're Looking For:** As a Clinical Documentation Quality Improvement (CDQI) Specialist, you will play a pivotal role ... Collaborate with physicians and caregivers to ensure appropriate reimbursement and clinical severity for DRG-based payer patients. + Demonstrate understanding of… more
- Trinity Health (Syracuse, NY)
- …cost-effective care. Works collaboratively with staff to obtain information from clinical reviews and medical records in order to provide the appropriate ... in the discussion and notification processes that result from the clinical utilization reviews with the facilitiesPer Diem- Insurance Specialist to assist… more
- Mount Sinai Health System (New York, NY)
- …to interact effectively with multidisciplinary teams, including physicians and other clinical professionals internally and externally. + The ability to maintain a ... CPT/HCPCS codes . + Work with various stakeholders for example, HIM, billing, clinical , and IT departments to resolve billing issues, update systems, and align… more
- Catholic Health (Buffalo, NY)
- …coded utilizing International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) and Current Procedure Terminology (CPT) classifications. ... Junior Medical Coders as necessary. Responsibilities: EDUCATION + Active coding certification CCS, CCS-P, CPC, CPMA or COC From...Candidates are required to take and successfully pass HCS coding test EXPERIENCE + Minimum of 3 years professional… more
- Bassett Healthcare (Cooperstown, NY)
- …improvement, will help facilitate best practice models, including charge capture, coding utilization and denial avoidance. + Responsible for supporting the daily ... revenue recovery throughout the organization by identifying charge capture, coding , andreimbursement problems, then recommending/implementing solutions to achieve AO… more