- VNS Health (Manhattan, NY)
- …request, performs peer reviews of work performance, including quality of care, clinical documentation, coding and billing practices, communication skills, and ... OverviewProvides clinical leadership to promote increased compliance with a...of Hedis and QARR quality measures, ICD-10 and CPT coding for reimbursement of services required Bilingual skills, 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 ... 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
- Veterans Affairs, Veterans Health Administration (Montrose, NY)
- …systems include current versions of the International Classification of Diseases (ICD) Clinical Modification (CM) and Procedure Coding System (PCS), Current ... systems include current versions of the International Classification of Diseases (ICD) Clinical Modification (CM) and Procedure Coding System (PCS), Current… 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
- VNS Health (Manhattan, NY)
- …for Medicare Advantage Risk Adjustment required + 2 years of experience in coding and/or clinical documentation education required + Working knowledge of medical ... metrics and patient charts, identifying opportunities to support precise clinical documentation. Collaborating with the Risk Adjustment and Quality teams,… more
- Regeneron Pharmaceuticals (Tarrytown, NY)
- …and LOINC and other biomedical ontologies. + Appreciation of nuances of clinical data from different sources ( coding , structure, classification). + Excellent ... a Physician Scientist in our TAG-CI (Therapeutic Area Genetics- Clinical Informatics) department to tap into the growing database...OHDSI tools and the OMOP data models + Excellent coding and quantitative skills and overall familiarity with modern… more