- UnitedHealth Group (Eden Prairie, MN)
- …leadership role provides oversight, support, and consultative guidance to the assigned Clinical Coding Pharmacists who support OptumRx's clinical ... take on some tough challenges. Primary Responsibilities: Provides oversight & support to Clinical Coding Pharmacists to help ensure superior, high quality … more
- Geisinger (Danville, PA)
- …physicians and non-physician practitioners, as determined appropriate. Serves as a clinical coding subject matter expert for multiple assigned specialties ... non-physician practitioners, leadership, and administrative staff on documentation and coding requirements. Determines the adequacy of medical record documentation, … more
- Elevance Health (Mason, OH)
- …the performance of medical audit activities. Draws on extremely advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to substantiate ... Capabilities and Experiences : BA/BS preferred. Experience with vendor based DRG Coding / Clinical Validation Audit setting or hospital coding or quality… more
- Elevance Health (St. Louis, MO)
- …will make an impact: Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines and objectivity in the performance of medical ... audit activities. Draws on advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to substantiate conclusions. Utilizes audit tools and… more
- UnitedHealth Group (Minneapolis, MN)
- … criteria documentation requirements used to successfully substantiate code assignments Perform clinical coding review to ensure accuracy of medical coding ... us to start Caring. Connecting. Growing together . In this position as a Coding & Clinical Auditor / DRG Specialist RN , you will apply your expert knowledge of… more
- Fairview Health Services (St. Paul, MN)
- …services, hospital billing outpatient services, hospital billing inpatient services. Coding Documentation Liaisons analyze clinical documentation verifying ... and other key stakeholders to improve the quality of documentation and coding to resolve clinical documentation and charge capture discrepancies. Position… more
- Commonwealth Care Alliance (Boston, MA)
- … Sr. Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and necessary coding configuration ... Duties & Responsibilities: Develop enhanced, customized prospective claims auditing and clinical coding and reimbursement policies and necessary coding… more
- CVS Health (St. Paul, MN)
- …Health Records (EHR) systems and clinical workflows. Understanding of clinical terminologies and coding systems (eg, SNOMED, LOINC, ICD10). Experience ... Position Summary: We are seeking an innovative and experienced Director of Engineering Clinical AI to lead our initiatives in developing and implementing advanced AI… more
- Trinity Health (Livonia, MI)
- …Experience working with current clinical processes, charge master maintenance, clinical coding guidelines, charging processes and audits, and clinical ... including but not limited to, appending modifiers, and checking clinical documentation. Provides feedback to intra-departmental Revenue Integrity colleagues… more
- Insmed Incorporated (NJ)
- …for all issues identified which may affect the quality and integrity of clinical studies.Perform medical monitoring, coding , and data cleaning, and prepare ... you?About the Role:We're looking for an Executive Medical Director of Ophthalmology, Clinical Development to help us expand what's possible for patients with serious… more
