- Molina Healthcare (Albuquerque, NM)
- …provision of member services in alignment with state, federal, accrediting, and billing / coding guidelines and regulations. Contributes to overarching strategy to ... * Nursing experience in critical care, emergency medicine, medical/surgical or pediatrics. * Billing and coding experience. To all current Molina employees: If… more
- Molina Healthcare (Buffalo, NY)
- …necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the ... Emergency Medicine, Medical Surgical, or Pediatrics. Advanced Practice Nursing. Billing and coding experience. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:**… more
- Methodist Health System (Dallas, TX)
- …audits for areas of concern to assure documentation standards are being met for billing / coding purposes. **_Duty 4_** : Assist in training and education of ... coders and staff on compliance billing and coding principles for government and...7_** : Assists in all other areas within the coding /auditing department as directed by Director/Audit Manager .… more
- BrightSpring Health Services (Longmont, CO)
- …with MS Excel, Word, Webex, MS Teams, and basic computer knowledge + Medical billing and coding experience desired + Strong written and verbal Communication, ... accounts by collecting the balance due or by taking other action (write-offs, billing to another source, in-house collections or referral to attorney or collections… more
- Open Sky Community Services (Worcester, MA)
- …and accounts receivable follow up to work under the direction of the Third-Party Billing Manager . The Accounts Receivable Specialist will be responsible for the ... and credit balances, present denial trends to Third Party Billing Manager for prevention and communicate with...billing agencies on charge entry, claim submissions and coding related issues. The ideal candidate must be proficient… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …or desk audits, clinical reviews of medical records to ensure correct billing of services and appropriateness of care, interviewing potential witnesses, developing ... contracts, group benefit structures, Corporate Medical Policies, the AMA CPT Coding Guidelines, HCPCS coding , inter-plan regulations, government policies, as… more
- Saint Francis Health System (Tulsa, OK)
- …understanding of Center for Medicare and Medicaid Services (CMS) regulations, payer billing guidelines, and coding compliance. Knowledge of revenue cycle ... with Epic Revenue Cycle modules including Charge Router, Resolute Hospital Billing /Professional Billing (HB/PB), Charge Description Master (CDM) tools, Reporting… more
- Johns Hopkins University (Middle River, MD)
- …claims and standard appeals, using various JHM applications and JHU/ PBS billing applications. Communicates with payers to resolve issues and facilitate prompt ... information required to produce a clean claim including special billing procedures that may be defined by a payer...higher-level specialist. + Informs the supervisor / Production Unit Manager of issues or problems associated with non-payment of… more
- Houston Methodist (Houston, TX)
- …and written communication. + Identifies denial trends and notifies supervisor and/or manager to prevent future denials and further delay in payments. Collaborates ... and provides support to other team members as advised by the manager and/or supervisor. **SERVICE ESSENTIAL FUNCTIONS** + Completes special projects to improve… more
- State of Colorado (Chaffee County, CO)
- …+ Education/certification in medical records, health information, medical assistant or medical billing and coding will substitute for the required experience on ... handled in conjunction with the Clinical Services Support Services Manager ; + Procure, track and record inmate health record...+ Experience as a Registered Health Information Technician, Medical Billing & Coding or Medical Assistant. +… more