- CVS Health (Nashville, TN)
- …Appeal Hearings / Special Projects and Committee participation when needed. The Medical Director will provide clinical , coding , and reimbursement expertise ... well as directing case management when necessary. The Medical Director will act as a business and clinical... Director will act as a business and clinical liaison to network providers and facilities if needed,… more
- Evolent (Nashville, TN)
- …addressing regular coding questions and issues. + Collaborate with the coding director to develop policies, procedures, and workflows to enhance department ... and that impact the team. Provide individual and team training on clinical documentation requirements, risk adjustment coding guidelines, and updates. +… more
- HCA Healthcare (Nashville, TN)
- … coding and documentation improvement education to Providers. + Assists the Director Coding Operations Division Support in reviewing progress against business ... and workflow, including but not limited to, practice acquisitions, provider clinical documentation improvement, practice coding processes, and division… more
- HCA Healthcare (Nashville, TN)
- … coding and documentation improvement education to Providers. + Assists the Director Coding Operations Division Support in reviewing progress against business ... and workflow, including but not limited to, practice acquisitions, provider clinical documentation improvement, practice coding processes, and division… more
- Covenant Health Inc. (Knoxville, TN)
- …coding staff. Working directly with the physicians, Manager of Corporate Coding Services, Director of Registration/Admitting, and medical staff education ... to coding . + Educates and assists physicians and clarifies coding versus clinical issues. + Works closely with Registration and Business Office personnel to… more
- Elevance Health (Nashville, TN)
- ** Clinical Documentation and Claims Integrity Director ** **Location:** Alternate locations may be considered. This position will work a hybrid model (remote and ... of life through home-care and community based services. The ** Clinical Document Improvement Director ** is responsible for...of related experience, including 3 years of hands-on HCC coding , chart review, and RAF calculations; or any combination… more
- Humana (Nashville, TN)
- …with business partners to uphold ethical standards and mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance, by ... data requires an in-depth evaluation of variable factors. As the Senior Clinical Compliance Professional, you will develop and/or evaluate compliance policies and… more
- Datavant (Nashville, TN)
- …to deliver complex healthcare technology solutions. + Solid understanding of clinical suspecting, concurrent coding workflows, risk adjustment models (eg, ... experiences to realize our bold vision for healthcare. **Role Overview** As the Director of Prospective + Concurrent Risk Adjustment Products, you will lead the… more
- Humana (Nashville, TN)
- …these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical … more
- Sumitomo Pharma (Nashville, TN)
- …highly motivated, and experienced individual for the position of **Associate Medical Director .** The Associate Medical Director will provide hands-on PVRM ... products. + Conduct safety surveillance over product life cycle, reviewing clinical trial and post-marketing Individual Case Safety Reports (ICSRs), including… more