- Humana (Albany, NY)
- …Nurse Auditor 2 validates and interprets medical documentation to ensure capture of all relevant coding . Applies clinical and coding experience to conduct a ... community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis … more
- SUNY Upstate Medical University (Syracuse, NY)
- …professional OB/GYN encounters. This position serves as a key liaison between coding , clinical , and compliance departments ensuring that all documentation and ... The role also includes providing ongoing education to OB/GYN providers and clinical staff on documentation quality, coding updates, and best practices… more
- Rochester Regional Health (Rochester, NY)
- …obligations. Audits include, but are not limited to revenue cycle ( Clinical documentation, EMR workflows, registration, coding , charging, billing, payments, ... implements training to ensure compliance with the revenue cycle focusing on clinical documentation, coding , charging, billing, and denial appeals for physicians,… more
- UHS (Binghamton, NY)
- …coding systems, MS-DRG and APR-DRG assignment, and comprehensive understanding of clinical documentation. The Level 3 coder ensures coding compliance, ... and complications. + Analyze detailed clinical documentation to identify relevant clinical indicators ensuring coding accuracy. + Perform and respond to… more
- Highmark Health (Albany, NY)
- …clinical outcomes, cost, and member experience. + **Operational Integration & Coding :** Engage non- clinical teams to ensure operational guidelines are aligned ... as a primary owner of assigned medical policies, ensuring their accuracy, clinical soundness, and operational feasibility. A core responsibility of this position is… more
- Weill Cornell Medical College (New York, NY)
- …This role is responsible for designing, managing, and evaluating comprehensive billing, coding , clinical documentation, and all other related education programs ... conducting compliance-related activities to provide guidance and support related to clinical documentation improvement, and coding reviews. + Support… 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
- Saratoga Hospital (Saratoga Springs, NY)
- …services from payers. This position provides a vital link between inpatient coding , clinical documentation improvement, Patient Access (PA) and Patient Financial ... HIS inpatient accounts, working with HIS Coders, payers, Department Directors, Clinical Managers, Case Management, Patient Access, and PFS. Actively contributes to… more
- Ankura (New York, NY)
- …+ Ankura's payer team brings a combination of compliance, operations, audit, clinical coding , data analytics, financial, valuation, and systems professionals to ... support payer executives and their counsel with regulatory compliance, operations, disputes, investigations, and transaction support and due diligence. + Ankura's pharmacy team assists counsel across the entire spectrum of pharmacy benefits, including retail,… more