- Molina Healthcare (Cincinnati, OH)
- …Association** Any one or more of the following: + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and...Long-Term Services & Supports issues. + Identifies and reports quality of care issues. + Prepares and presents cases… more
- Elevance Health (Mason, OH)
- …state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years ... Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement… more
- Banner Health (OH)
- …documentation completed by the health care team for the health record(s) and for quality assurance in the alignment of clinical documentation and billing codes. ... Works with clinical documentation improvement and quality management staff to: align diagnosis coding to documentation to improve the quality of clinical … more
- Cleveland Clinic (Euclid, OH)
- … quality , and patient experience. + Support the medical staff peer review and committees for quality improvement. + Ensure ongoing professional practice ... a cornerstone of our mission. As a Patient Service Specialist , your responsibility is to deliver an exceptional experience...and support teams to develop and maintain an integrated quality plan to achieve safety, quality and… more
- CVS Health (Columbus, OH)
- …of working from home. **Position Summary** + Responsible for performing second level quality inter-rater review audits of medical records coded by internal team, ... each and every day. Aetna's Revenue Integrity team is hiring Senior Coding Data Quality Auditors to support our growing risk adjustment efforts. This role plays a… more
- CVS Health (Columbus, OH)
- …purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and ... and directives. + Demonstrates a strong commitment to enhancing and promoting quality ; consistently delivers accurate and thorough work, and supports others in… more
- CVS Health (Columbus, OH)
- …purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and ... conditions + Diagnosis codes must be appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal… more
- Evolent (Columbus, OH)
- …when available, within the regulatory timeframe of the request. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the ... Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. + Ensures documentation of all communications with… more
- Veterans Affairs, Veterans Health Administration (Dayton, OH)
- …by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities Total Rewards of a Allied Health ... follow-up) within 30 minutes. Utilizes the Whole Health approach in clinical practice, including connecting with the Veteran's Mission/Aspiration/Purpose to inform,… more
- BioLife Plasma Services (Mentor, OH)
- …therapy Satisfactorily complete the FDA approved training requirements for BioLife Medical Support Specialist Two years in a clinical or hospital setting What ... day, the donors you meet will motivate you. The high- quality plasma you collect will become life-changing medicines. Here,...Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse) to support plasma center operations.… more