- Highmark Health (Nashville, TN)
- …to prevent further improper payments.Forwards case to the Credentialing and/or Medical Review Committee, law enforcement and regulatory agencies. + Responsible for ... and external law enforcement and regulatory agencies, Credentialing or Medical Review Committee. + Engages in delivery of audit...1 year in Financial Analysis in an acute care hospital or health insurance setting + 1 year in… more
- Cardinal Health (Nashville, TN)
- …multi-job functions. + Knowledge of medical terminology and electronic medical records. + Professional and/or hospital services auditing experience. + ... accuracy and adequacy of documentation and coding related to physician or hospital (inpatient and outpatient) billing and/or medical necessity reviews. +… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The DRG Denials Auditor conducts hospital inpatient DRG denial audits for both RAC and non-RAC accounts, reviewing patient records for accuracy in ... appropriate coding references for CHS hospitals via scanned, electronic and hybrid medical records. Based on review findings, writes appeal letters to include… more
- Elevance Health (Nashville, TN)
- …(CDI, MS-DRG, AP-DRG and APR-DRG)** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs ... you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of … more
- HCA Healthcare (Nashville, TN)
- …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and… more
- HCA Healthcare (Nashville, TN)
- …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and… more
- CenterWell (La Vergne, TN)
- …the coordination of patient services, including but not limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health ... Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators… more
- CenterWell (Smyrna, TN)
- …the coordination of patient services, including but not limited to specialty referrals, hospital and SNF coordination, durable medical equipment, and home health ... accordance with standards of care. + Follows level of medical care and quality for patients and monitors care...in a timely manner working with a quality- based coder to optimize coding specificity. + Follows policy and… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Coder Supervisor, Clinical Document Integrity Full-time, 80 hours per pay period, Days Covenant Medical Group is Covenant Health's employed and managed ... supervision of employees of the CDI department at Covenant Medical Group. Monitors the following on a daily basis...state and financial regulatory approach mandatory, as well as hospital finance, needed. Three (3) years coding experience required.… more
- HCA Healthcare (Nashville, TN)
- …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and… more