- Kaleida Health (Buffalo, NY)
- …the clinical team and collaborates extensively with Physicians/Providers, HIM coding team, Nursing, Patient Management, Quality Department and ancillary staff to ... perform concurrent analytical review of clinical documentation and coding data.The CDS facilitates obtaining appropriate clinical documentation for any … more
- Excellus BlueCross BlueShield (Rochester, NY)
- … coding , Medicare Advantage and Commercial Hierarchical Condition Category (HCC) coding , and Medicaid Clinical Risk Groups (CRGs) to ensure compliance. ... we encourage you to apply! Job Description: Summary: The Risk Adjustment Coding Coordinator is responsible for various aspects of decision-making and implementation… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Operations) and supporting systems. (BREADTH). + Expertise in complex clinical coding /reviewing assignments, difficult investigations and highly visible ... of the SIU Management, this position is responsible for the accurate and thorough clinical investigation of potential fraud, waste and abuse (FWA) for all lines of… more
- Humana (Albany, NY)
- …of our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and ... medical codes (eg, ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the… more
- Mount Sinai Health System (New York, NY)
- …of Epic (required) and Meditech (preferred) systems, and collaborate cross-functionally with clinical , financial, coding , and IT teams to ensure accurate and ... an experienced Senior Financial Analyst / CDM Chargemaster with strong medical coding expertise to support the maintenance, compliance, and optimization of the… more
- Datavant (Albany, NY)
- …to deliver complex healthcare technology solutions. + Solid understanding of clinical suspecting, concurrent coding workflows, risk adjustment models (eg, ... and acting on undiagnosed conditions (prospective suspecting) and ensuring risk adjustment coding accuracy in near real-time (concurrent review). You will manage a… more
- WMCHealth (Kingston, NY)
- …attend inservices given by physicians, ask questions, assist physicians in clarifying coding / clinical issues. + Participate in coding audits/PI monitors ... - Remote Company: HealthAlliance Hospital City/State: Kingston, NY Category: Professional/Non- Clinical Department: Medical Records Union: No Position: Full Time… more
- CVS Health (New York, NY)
- …Responsible for predetermination reviews ad reviews of claim determinations, providing clinical , coding , and reimbursement expertise, using multiple computer ... system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. **This is a… more
- WMCHealth (Valhalla, NY)
- … improvement activities. Monitors and reports key performance indicators relative to clinical documentation and HCC coding . . Documents and maintains records ... competencies in clinical documentation improvement and ICD, CPT and HCC coding through continuing education. Assists with compliance audits and other duties as… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …+ Provides clinical expertise on ARD cases, Quality of Care cases, clinical editing, coding reviews and inquiries. + Makes accurate and consistent ... surgical services at first level, appeal and inquiries. + Conducts peer-to-peer clinical reviews with attending physicians or other providers to discuss review… more