- Banner Health (CA)
- …Demonstrates extensive knowledge of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group ... clinical documentation to ensure that clinical coding is accurate for proper reimbursement and that coding compliance is complete. Provides feedback on coding work… more
- Molina Healthcare (San Diego, CA)
- …achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for ... understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape recommendations and action plans. + Translates… more
- Banner Health (CA)
- …information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or ... and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health… more
- Banner Health (CA)
- …information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or ... and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health… more
- Banner Health (CA)
- …information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or ... and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health… more
- Sharp HealthCare (San Diego, CA)
- …or Equivalent; Certified Professional Coder (CPC) - AAPC; Certified Coding Specialist (CCS) - The American Health Information Management Association (AHIMA); ... etc. + Certified Professional Coder (CPC) - AAPC **OR** Certified Coding Specialist (CCS) - The American Health Information Management Association (AHIMA) -REQUIRED… more
- LA Care Health Plan (Los Angeles, CA)
- …clinical and/or coding expertise/judgement in the application of medical and reimbursement policies within the claim adjudication process through medical record ... auditing experience. Skills Required: Knowledge in CPT, HCPCS, ICD-9, ICD-10, Medicare , and Medicaid rules and regulations. Knowledge of healthcare reimbursement… more
- Highmark Health (Sacramento, CA)
- …topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles ... system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare… more
- Cardinal Health (Sacramento, CA)
- …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will ... claims, including appeals and denials, to ensure timely and accurate reimbursement . + Processes denials & rejections for re-submission (billing) in accordance… more