- Cardinal Health (Lincoln, NE)
- …and coding related to physician or hospital (inpatient and outpatient) billing and/or medical necessity reviews. + Prepares written reports of audit ... state regulations and laws, CMS and other third-party payer billing rules and internal documentation, coding and...+ 6+ years of experience in physician and/or hospital coding and auditing, medical necessity reviews, or… more
- CVS Health (Lincoln, NE)
- … certification - Certified Professional Coder (CPC) + 3+ years of experience in medical coding or documentation auditing. + Strong knowledge of standard industry ... **Position Summary** The Certified Professional Coder (CPC) will perform medical claim reviews to ensure compliance with coding...patterns or trends. Activities include: - Conduct a comprehensive medical record review to ensure billing is… more
- Molina Healthcare (Grand Island, NE)
- …performing accurate and reliable medical review audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing ... responsible for recognizing and adhering to national and local coding and billing guidelines in order to...programs as well as Marketplace. + Understanding of claim billing codes, medical terminology, anatomy, and health… more
- Omaha Children's Hospital (Omaha, NE)
- …framework of respective scope of practice. + Must be knowledgeable in billing regulation practices to include documentation requirements/CPT coding regulations. ... ◦ Preforms diagnostic and therapeutic procedures; prescribes medications and complex medical regimes while monitoring for desired and adverse outcomes, specific to… more
- Cardinal Health (Lincoln, NE)
- …vendors supporting any patient billing and collections processes + Collaborate with billing , coding , posting and front office teams to resolve account issues ... Practice Operations Management oversees the business and administrative operations of a medical practice. Revenue Cycle Management manages a team focused on a series… more
- Omaha Children's Hospital (Omaha, NE)
- …School Diploma or GED equivalent Required and + Associate's Degree in Billing , Coding , Business, Finance, or related field Required **Experience Qualifications** ... Analyst provides assistance with ongoing education, training and monitoring of Central Billing Office staff. Completes audits on work that involves charge entry,… more
- Catholic Health Initiatives (Omaha, NE)
- …reasoning based on EOBs, reimbursement, and payer specific requirements. + Review patient medical record to compare documentation and coding ; change coding ... payers to address and resolve outstanding insurance balances related to coding denials in accordance with established standards, guidelines and requirements. The… more
- Molina Healthcare (NE)
- …and state specific policies and regulations in order to identify incorrect coding , abuse and fraudulent billing practices, waste, overpayments, and processing ... modules within the core processing system (QNXT). * Conducts focal healthcare Medical claim audits on samples of processed transactions impacted by these… more
- Fresenius Medical Center (Grand Island, NE)
- …communicated to and implemented by the facility staff. + Maintains integrity of medical records and other FMS administrative and operational records. + Complies with ... as pertinent. **STAFF:** + Responsible for implementation of FMS staffing, and medical supply models, to provide quality patient care, and makes recommendations. +… more
- Humana (Lincoln, NE)
- …Investigator: Nurse Audit/Review performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services ... interprets medical documentation to ensure capture of all relevant coding . Identifies members with high-risk CMS Hierarchical Condition Categories (HCC) and… more