- LA Care Health Plan (Los Angeles, CA)
- …Management projects. The position serves as a subject matter expert (SME), performing medical records reviews to include quality audits as well as validation ... Payment Integrity Nurse Coder RN III Job Category: Clinical...providing clinical and/or coding expertise/judgement in the application of medical and reimbursement policies within the claim adjudication process… more
- Veterans Affairs, Veterans Health Administration (San Diego, CA)
- …codes for each diagnosis and procedure. Responsibilities The journey level Medical Records Technician ( Coder -Inpatient) position incumbent selects ... who are in this occupation and meet the criteria). Grade Determinations: GS-8 Medical Records Technician ( Coder -Outpatient-Inpatient) Experience: One year of… more
- Stanford Health Care (Palo Alto, CA)
- …and comprehensive appeal letters to payors after a detailed review of medical records . Ensure compliance with Medicare, Medicaid, third-party guidelines, Local ... Denial Analysis: Conduct thorough analyses of denials, evaluating the appropriateness of medical services and procedures. Ensure accurate coding with ICD, HCPCS, CPT… more