- Humana (Albany, NY)
- …Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider ... community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from...one of these qualifications for 4 years) * MS-DRG coding /auditing experience * Experience reading and interpreting claims… more
- Ideal Home Care (Islandia, NY)
- …with healthcare regulations. Key Responsibilities: + Curriculum Delivery: Teach medical billing and coding courses, including healthcare terminology, ... ICD-10, CPT, HCPCS coding systems, insurance claims , reimbursement processes, and regulatory compliance. + Instructional Methods:...+ Minimum of 2 years of professional experience in medical billing, coding , or healthcare … more
- University of Rochester (Rochester, NY)
- …+ Demonstrated working knowledge of the professional billing software applications + Active medical coding credential with AHIMA as RHIT, RHIA, CCS, CCS-P, AAPC ... charging and receivables. These activities include, but are not limited to, coding abstraction, pre-bill coding edits, claims resolution functions,… more
- Highmark Health (Albany, NY)
- …for education/training of facility healthcare professionals in use of coding guidelines and practices, proper documentation techniques, medical terminology ... **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data… more
- Independent Health (Buffalo, NY)
- …statistics. + Perform validation of diagnosis and procedure coding by reviewing medical record documentation and/or provider claims data. Ensure coding ... culture that fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist-Senior will be responsible for reviewing coding and… more
- Cognizant (Albany, NY)
- …High School Diploma or equivalent is required + A minimum of 1 years of medical claims processing is required + Facets experience is highly preferred + Knowledge ... Claims Processors to join our growing team. The ** Medical ** ** Claims Processor** is responsible for the...of physician practice and hospital coding , billing, and medical terminology, CPT, HCPCS,… more
- FlexStaff (Chappaqua, NY)
- …Number** 168166 Claims Management Specialist Are you a seasoned medical insurance professional with a passion for leadership and operational excellence? ... excel at team management, and have deep expertise in healthcare insurance billing, this is your chance to make...Qualifications: - Minimum of 3-5 years of experience in medical insurance billing and claims management, with… more
- Molina Healthcare (Rochester, NY)
- …or equivalent combination of education and experience **PREFERRED EXPERIENCE:** 3+ years healthcare Medical claims auditing **PHYSICAL DEMANDS:** Working ... to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of...within the core processing system (QNXT). * Conducts focal healthcare Medical claim audits on samples of… more
- Molina Healthcare (Rochester, NY)
- …will work on set schedule) Looking for a RN with experience with appeals, claims review, and medical coding . **Job Summary** Utilizing clinical knowledge ... refers members with special needs to the appropriate Molina Healthcare program per policy/protocol. **JOB QUALIFICATIONS** Graduate from an...two years of experience in Claims Auditing, Medical Necessity Review and Coding experience +… more
- Molina Healthcare (NY)
- …different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding /billing (UB04/1500 form) + Demonstrated understanding of key managed ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical… more