- University of Southern California (Alhambra, CA)
- …legibly, and in a timely fashion. * Performs other duties as requested/assigned by Director , Manager, Supervisor, or designee. + CODING & ABSTRACTING ACCURACY * ... conventions. * Ability to improve APC/HCC assignments based on medical necessity documentation & coding of PDx,...Ability to communicate changes to improve processes to the director , as needed. * Assists in department and section… more
- University of Southern California (Los Angeles, CA)
- …by Director , Manager, Supervisor, or designee. + TIMELINESS OF AUDITING/ CODING & PRODUCTIVITY 1. Maintains at minimum, expected productivity standards, and ... in Medical Terminology, Anatomy & Physiology and a certified coding course + Combined education/experience can substitute for Completion of Specialized/Technical… more
- Sharp HealthCare (San Diego, CA)
- …(HIM, CDI, Case Management, Quality, etc.) in developing SHC's standardized documentation, medical necessity, coding and billing policies and guidelines in ... practices. *This is a remote position* **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's)… more
- Emanate Health (Covina, CA)
- …the oversight of HCC Program and STAR measures coding related functions. The coding specialist will work with the IPA Director , Health Plan, and MSO ... submitted for Medicare and Covered CA lines of business. Coding specialist will be responsible to review medical... Coding specialist will be responsible to review medical records and claims data to ensure external physicians… more
- CVS Health (Sacramento, CA)
- …day. **Position Summary** Aetna, a CVS Health company, has an outstanding opportunity for a Medical Director . Ready to take your career to the next level with a ... anywhere in the United States. In this role as Medical Director MPO ( Medical Policy...direction in these areas. Knowledge of Aetna clinical and coding policy and experience with appeals, claim review, reimbursement… more
- CenterWell (Sacramento, CA)
- **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health ... claims. The Medical Director , Primary Care work assignments involve moderately complex to...An aspect of the role includes an overview of coding practices and clinical documentation, grievance and appeals processes,… more
- Humana (Sacramento, CA)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...but may not be limited to, an overview of coding practices and clinical documentation, grievance and appeals processes… more
- Sharp HealthCare (San Diego, CA)
- …made by our recruitment and hiring teams. **What You Will Do** The System Director of Revenue Cycle, Quality, and Audit is responsible for directing the development ... teams to assess and improve the quality of registration, revenue and coding systems to ensure compliance, reimbursement accuracy, and denial management and… more
- Humana (Sacramento, CA)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests ... for services. The Medical Director work assignments involve moderately complex...conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes,… more
- Humana (Sacramento, CA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
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