- Catholic Health Services (Melville, NY)
- …potential chronic diagnoses + "Clinical detective" mindset to look for new HCC diagnosis capture opportunities based on appropriate clinical indicators + Validation ... clinical documentation to support diagnoses These reviews are in contrast to coding /compliance reviews, which evaluates what is written in the encounter note… more
- Deloitte (New York, NY)
- …quality improvement, and value-based payment models + Proven applicable CPT and ICD-10 coding experience; APR-DRG, MS-DRG and HCC assignment + Other revenue ... for inpatient and outpatient service areas for accuracy of coding and documentation to ensure regulatory compliance + Apply...and follow-up entries in medical records to lead to coding accuracy + Identify gaps in clinical documentation and… more
- Datavant (Albany, NY)
- …will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, ... in neurosurgery and orthopedics. Experience in Interventional Radiology and HCC is a plus. **You Will:** + Conduct inpatient... is a plus. **You Will:** + Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and… more
- J&J Family of Companies (New York, NY)
- …authorizations and appeals, reimbursement processes, claims submissions, procedures, and coding requirements of payer organizations (local payers, government payers, ... regional, local, and account market dynamics including coverage and coding requirements. + Grow the knowledge of hub and...departments such as marketing, sales, medical science, SCG, IBG, HCC , and PECS. Serve as subject matter expert regarding… more
- Humana (Albany, NY)
- …audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support ... and interprets medical documentation to ensure capture of all relevant coding . Identifies members with high-risk CMS Hierarchical Condition Categories ( HCC… more
- Mount Sinai Health System (New York, NY)
- …LCD/NCDs. Extensive understanding of reimbursement theories to include DRG, OPPS, HCC and managed care. Extensive working knowledge of health care compliance. ... Communicates and reviews impact on operations of third-party requirements for charging, coding or billing changes with defined stakeholders. + Develops and or… more