- Molina Healthcare (Cleveland, OH)
- …of stay, level of care, and inpatient readmissions. + Validates member medical records and claims submitted/correct coding, to ensure appropriate reimbursement ... medical necessity and appropriate/accurate billing and claims processing. + Reevaluates medical claims and associated records by applying advanced clinical… more
- Elevance Health (Mason, OH)
- …based sponsorship. **Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective ... and accurate reimbursement criteria.** PRIMARY DUTIES: + Review medical record documentation in support of Evaluation and Management, CPT, HCPCS and ICD-10 code. +… more
- Datavant (Columbus, OH)
- …new and existing coders. **You Will:** + Conduct inpatient coding audits on medical records , utilizing ICD-10-CM, CPT, and appropriate coding references for ... accurate DRG and APC assignment. + Review non-CC/MCC records to assess proper coding or identify the need...and Auditing software **Perks:** + Benefits for Full-Time employees: Medical , Dental, Vision, 401k Savings Plan w/match, 2… more
- Datavant (Columbus, OH)
- …compliant coding practices across multiple specialties. **What You Will Do:** + Review medical records and assign accurate codes for diagnoses and procedures. + ... encoding and abstracting software **What We Offer:** + Benefits for Full-Time employees: Medical , Dental, Vision, 401k Savings Plan w/match, 2 weeks of paid… more
- Datavant (Columbus, OH)
- …System experience with Meditech and 3M required **What You Will Do:** + Review medical records and assign accurate codes for diagnoses and procedures. + Assign ... encoding and abstracting software **What We Offer:** + Benefits for Full-Time employees: Medical , Dental, Vision, 401k Savings Plan w/match, 2 weeks of paid… more
- Molina Healthcare (Akron, OH)
- …medical providers. This position uses information from a tip, member benefits, and medical records to document relevant findings of a post pay clinical ... for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of claims payments. +… more
- Elevance Health (Mason, OH)
- …abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new healthcare-related questions as ... SIU** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to… more
- Datavant (Columbus, OH)
- …Profee ED **What You Will Do:** + Performs Outpatient Facility coding audits of medical records and abstracts using ICD-10-CM, CPT, HCPCS, and modifiers and ... to ensure departmental workflow and case resolution + Provides coder education via the auditing process + Function in...EMRs **What We Offer:** + Benefits for Full-Time employees: Medical , Dental, Vision, 401k Savings Plan w/match, 2… more
- Datavant (Columbus, OH)
- …experiences to realize our bold vision for healthcare. As an Auditor, HCC Risk Adjustment Coder , you will review medical records to identify and code ... will bring to the table:** + Minimum 3 years of HCC coding experience + Minimum 2 years of HCC Auditing experience + High school diploma or GED equivalent + AHIMA… more
- Molina Healthcare (OH)
- …to determine appropriate appeals and grievance outcomes. * Requests and reviews medical records , notes, and/or detailed bills as appropriate; formulates ... requests from outside agencies. **Required Qualifications** * At least 2 years of managed care experience in a call...care related vocational program in health care (ie, certified coder , billing, or medical assistant). To all… more