- Penn Medicine (Philadelphia, PA)
- …coding quality and reimbursement. Provide individual and group education to Coding staff, Clinical Documentation Improvement (CDI) Specialists, Providers and ... safety rating scores and quality of care statistics Assist HIM Coding Quality team with clinical validation audits and provide support for coding quality… more
- Humana (Harrisburg, PA)
- …caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of medical records ... evaluation of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis related group (DRG) assignments.… more
- Datavant (Harrisburg, PA)
- …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
- Genesis Healthcare (PA)
- …and drive performance improvements. *Build strong relationships with finance, billing, coding , and clinical operations teams, collaborating to develop and ... with your exceptional analytical and collaborative skills, to drive accurate clinical outcomes for incentive payments. Position Highlights *Plan, coordinate, and… more
- CVS Health (Pittsburgh, PA)
- …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 (Harrisburg, PA)
- …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
- Penn Medicine (Philadelphia, PA)
- …to instruct the clinical teams in appropriate documentation as suggested by CMS coding guidelines and to ensure that the clinical chart is the true and ... of severity in care team documentation w consideration of CMS coding guidelines + Provide clinical care teams with ongoing education and training on current… more
- CVS Health (Harrisburg, PA)
- …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
- UPMC (Pittsburgh, PA)
- …+ Coordinate and present education of providers/practices related to risk adjustment, coding , and clinical documentation improvement. + Assess workflow processes ... for participating providers to address issues, questions and learning needs related to coding and documentation in the medical record and the various risk adjustment… more
- Highmark Health (Pittsburgh, PA)
- …strategy to achieve continuous improvements as it relates to Quality and Coding for the Highmark Health Enterprise. Ensures that Highmark's Risk Adjustment programs ... to deliver the highest quality of care to Highmark members and improve clinical documentation accuracy and completeness. Creates a culture focused on Compliance and… more