- Elevance Health (Mason, OH)
- …determined to recover, eliminate and prevent unnecessary medical -expense spending. The Manager of DRG Coding Audit & Clinical Validation leads a ... ** Manager DRG Coding Validation ( Manager...** Manager DRG Coding Validation ( Manager Program and Project...with ICD-9/10CM, MS-DRG and APR-DRG. + Broad knowledge of medical claims billing /payment systems provider billing… more
- Highmark Health (Columbus, OH)
- …performing audits and research related to special projects and providing coverage for coding manager (s). (10%) + Depending on location provides or arranges for ... **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data… more
- Premier Health (Moraine, OH)
- …up on submitted claims that are unpaid, rejected, or denied. The Medical Billing Specialist reports to the A/R Manager within the Centralized Billing ... Billing Office** **FT/ DAYS/ 80 hours per pay** **Summaryof Position** The Medical Billing Specialist works to ensure timely and accurate reimbursement on … more
- Cognizant (Columbus, OH)
- **About the role** As an Inpatient Medical Coding Auditor, you will make an impact by auditing consultant inpatient. You will be a valued member of the Cognizant ... and ICD-10-PCS education and mentoring to Company's clients in coding , billing and compliance + Perform Peer...Federal, state and payer regulations + Capable of interpreting medical records reports and chart entries + Able to… more
- Elevance Health (Mason, OH)
- …The ** Coding Analyst Senior** is responsible for reviewing, auditing, and coding medical records for the purpose of reimbursement, training, education and ... you will make an impact:** + Audits and reviews medical documentation for appropriate ICD-9 and CPT coding...physicians and providers with questions and problems related to coding , documentation and billing . + Serves as… more
- Cardinal Health (Columbus, OH)
- …services and/or hospital (technical) services, including: detection and correction of documentation, coding , and billing errors and/or medical necessity of ... support of services billed; compliance with other documentation and coding and billing standards; communication of audit... related to physician or hospital (inpatient and outpatient) billing and/or medical necessity reviews. + Manages… more
- Molina Healthcare (Cleveland, OH)
- …and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding / billing (UB04/1500 form) + Demonstrated understanding of key ... **JOB DESCRIPTION** **Job Summary** The Manager , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key… more
- Cardinal Health (Columbus, OH)
- …Administration, Business, or related field preferred + 5+ years of experience in medical billing and insurance follow-up, with 2+ years in a leadership ... performance evaluations for AR follow-up staff. + Coordinate with billing , coding , and other departments to address...or supervisory role preferred. + Strong understanding of medical billing practices, payer guidelines, and reimbursement… more
- Molina Healthcare (Akron, OH)
- …level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and ... Medicine, Medical Surgical, or Pediatrics. Advanced Practice Nursing. Billing and coding experience. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:**… more
- Elevance Health (Mason, OH)
- …you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance ... of medical audit activities. + Draws on advanced ICD-10 coding expertise, mastery of clinical guidelines, and industry knowledge to substantiate conclusions. +… more