- Molina Healthcare (Vancouver, WA)
- …Complex Claim review including DRG Validation, Itemized Bill Review , Appropriate Level of Care, Inpatient Readmission, and any opportunity identified ... set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical knowledge and experience,… more
- Molina Healthcare (Bellevue, WA)
- …all claim types of reimbursements not limited to payment methodologies such Stoploss, DRG , APC, RBRVS, FFS applicable for HD Inpatient , Outpatient and ... **Job Description** Responsible for comprehensive contract review and target claim audits review . This includes but not limited to; deep dive contract review … more
- Cardinal Health (Olympia, WA)
- …and adequacy of documentation and coding related to physician or hospital ( inpatient and outpatient) billing and/or medical necessity reviews. + Manages focused ... data analytics and the revenue cycle team in identifying the time period of review and conducts a focused audit to identify any financial liability of the Company.… more
- Molina Healthcare (Spokane, WA)
- …**E** **N** **C** **E:** + Min. 6 years' experience in healthcare claims review and/or member dispute resolution. + 2 years leadership experience + Experience ... reviewing all types of medical claims (eg HCFA 1500, Outpatient/ Inpatient UB92, Universal Claims, Stop Loss, Surgery, Anesthesia, high dollar complicated claims, COB… more
- Molina Healthcare (Vancouver, WA)
- …experience. **Required Experience** * 7 years experience in healthcare claims review and/or member appeals and grievance processing/resolution, including 2 years in ... Experience reviewing all types of medical claims (eg HCFA 1500, Outpatient/ Inpatient UB92, Universal Claims, Stop Loss, Surgery, Anesthesia, high dollar complicated… more