- Elevance Health (Seven Hills, OH)
- …not limited to: + 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, mastery of clinical guidelines, and industry knowledge...ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG; or any combination of education and experience, which would provide an equivalent background.… more
- LA Care Health Plan (Los Angeles, CA)
- …III is responsible for investigating, reviewing, and providing clinical and/or coding expertise/judgement in the application of medical and reimbursement policies ... well as validation of accuracy and completeness of all coding elements. The position is also responsible for guidance...as needed. Performs other duties as assigned. Duties Continued Education Required Associate's Degree in Nursing Education … more
- Trinity Health (Livonia, MI)
- …processes to improve performance and achieve defined goals. Provides training and education to clinical documentation specialists (CDS) to enhance clinical and ... coding skill sets and optimal utilization of 3M CDI...to diversity includes a unified workforce (through training and education , recruitment, retention, and development), commitment and accountability, communication,… more
- Avera (Sioux Falls, SD)
- …the accommodations do not cause undue hardship to the employer. **Required Education , License/Certification, or Work Experience:** + Certified Coding Specialist ... + Focused on determining the appropriate DRG based on insurance and/or medical coding for inpatient charts or other charts as necessary for the inpatient service… more
- Avera (Sioux Falls, SD)
- …the accommodations do not cause undue hardship to the employer. **Required Education , License/Certification, or Work Experience:** + Certified Coding Specialist ... opportunities. + Focus on determining the appropriate APC/EAPC and/or appropriate medical coding for a variety of outpatient patient types including, but not limited… more
- Johns Hopkins University (Baltimore, MD)
- The Center for Technology in Education in the School of Education at Johns Hopkins University seeks a **_Software Engineer - AI Focus_** to support the ... every job responsibility. _Analysis & Requirements Gathering_ + Define complex business/clinical/ education problems by meeting with clients to observe and understand… more
- CGI Technologies and Solutions, Inc. (Dallas, TX)
- …defender of payment accuracy, reviewing complex medical records to ensure that coding and reimbursements for Commercial and Government health plans are precise and ... well-supported. You will leverage your deep inpatient coding expertise and clinical intuition to identify improper payments while producing thoroughly documented… more
- MTA (New York, NY)
- …in a timely manner. + Assist less experienced software developers/analysts in solving coding and technical issues related to MTA software. Level 4 Same as Level ... and resolve production problems and assist other technical support staff in solving coding and technical issues related to MTA software applications. + Lead the… more
- Sharp HealthCare (San Diego, CA)
- …an applicant's years of experience, unique skills and abilities, education , alignment with similar internal candidates, marketplace factors, other requirements ... and hiring teams. **What You Will Do** To provide coding support and appeal guidance relating to reimbursement issues....payer trends. **Required Qualifications** + 5 Years Experience with coding , auditing and patient account follow up in a… more
- Highmark Health (Columbus, OH)
- …clinical outcomes, cost, and member experience. + **Operational Integration & Coding :** Engage non-clinical teams to ensure operational guidelines are aligned with ... clinical policy intent. Develop and maintain a thorough understanding of medical coding (ICD-10, CPT, HCPCS) and ensure accurate coding principles are… more