- St. Mary's Healthcare (Amsterdam, NY)
- …organization to include the oversight of coding staff to ensure accurate coding for reimbursement and clinical care. + Establish and monitor coder ... according to regulations. + Identifies, implements, and maintains medical coding quality and compliance within regulatory and accreditation standard requirements.… more
- WMCHealth (Valhalla, NY)
- …departments. + Identify pre-bill and post-bill claim edits involving any type of clinical or coding review or required modifier based on services rendered. ... are captured & appealed in a timely manner. Coordinating appeal discussions with clinical & third party payors. + Develop, Implement and coordinate billing practices… 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
- CVS Health (Albany, NY)
- …Projects and Committee participation when needed. The Medical Director will provide clinical , coding , and reimbursement expertise as well as directing case ... 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 remote… more
- Stony Brook University (Stony Brook, NY)
- …the Clinical Documentation Data Analyst will provide support to the Clinical Documentation and Coding divisions. The Entry-Level Clinical Documentation ... valuable members of our team. Reporting to the Supervising Data Analyst for Clinical Documentation Integrity (CDI), ultimately reporting up to the Director of CDI,… 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
- Glens Falls Hospital (Saratoga Springs, NY)
- …payment arrangements * Contact provider/payer to obtain prior authorization * Gather additional clinical and / or coding information as necessary in order to ... * Prepare and compile necessary documentation to secure prior authorization. Collect clinical information regarding service to be rendered as applicable (as well as… more
- Glens Falls Hospital (Glens Falls, NY)
- …payment arrangements . Contact provider/payer to obtain prior authorization . Gather additional clinical and / or coding information as necessary in order to ... Prepare and compile necessary documentation to secure prior authorization. . Collect clinical information regarding service to be rendered as applicable (as well as… more
- CVS Health (Albany, NY)
- …Projects and Committee participation when needed. The Medical Director will provide clinical , coding , and reimbursement expertise as well as directing case ... transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources....The Medical Director will act as a business and clinical liaison to network providers and facilities if needed,… 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