- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …and identifies actionable opportunities for providers to improve their Quality and Coding Accuracy performance. The role leads face-to-face meetings with leaders in ... plans. The consultants are in-house subject matter experts on coding accuracy and Quality programs such as including HEDIS...Quality (CPHQ) or Certification in Health Care Quality and Manager (CHQM) * Registered Nurse * Solid knowledge of… more
- Hartford HealthCare (Farmington, CT)
- …1 is responsible for extensive record review, and interaction with physicians, HIM coding professionals, nursing staff and other patient care givers to ensure the ... . Meets program quality and productivity guidelines and standards. . Participates in Coding /CDI meetings and CDI H3W work group. . Inputs review workflows and… more
- Unum Group (Portland, ME)
- …degree or equivalent - IMS for z/OS + Knowledge of IMS Database Manager , DBD source and generation, understanding of Database Recovery Control [DBRC] information and ... commands, BMP and basic DL/I coding imbedded in COBOL source. + Familiarity with IMS...imbedded in COBOL source. + Familiarity with IMS Transaction Manager , including basic control region and message region processing,… more
- EPAM Systems (Houston, TX)
- …ever-growing Allegro practice. Technical consultants are responsible for designing, coding , testing and implementing product customization and interfaces while ... **Responsibilities** + Collaborate with and take guidance from the project manager or principal consultant on work assignments + Participate in, contribute… more
- UPMC (Pittsburgh, PA)
- …audits and investigations highly preferred. Under the direction of the manager , the Special Investigations Unit (SIU) Investigator is responsible for investigating ... trends using fraud detection software and/or as assigned by Manager . - Present FWA training to internal staff. -...Perform dental chart reviews to assess compliance with dental coding and billing regulations. - Utilize standard coding… more
- Mount Sinai Health System (New York, NY)
- …responsible for the trauma registry (with support from Trauma Program Manager and Trauma PI Coordinator) including accuracy, completeness, confidentiality of ... trauma registrar analyzes and interprets all available patient data to determine coding classifications including ICD-9/10 and AAAM in compliance with the American… more
- McLaren Health Care (Lansing, MI)
- …procedures at the end of the shift. 13. Maintains current knowledge on insurance/ coding information via communication with the Manager and billing office. 14. ... Develops and maintains knowledge regarding the billing system, scheduling, collections, etc. 15. Maintains effective verbal and nonverbal communications with staff and patients including: 16. Receives, documents and delivers telephone and other verbal… more
- Elevance Health (Seattle, WA)
- …as necessary to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations. + Collaborates with the ... Requires a AA/AS and minimum of 3 years medical coding /auditing experience, including minimum of 1 year in fraud,...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Molina Healthcare (Rio Rancho, NM)
- …readmissions. + Validates member medical records and claims submitted/correct coding , to ensure appropriate reimbursement to providers. + Resolves escalated ... services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. +… more
- BayCare Health System (Tampa, FL)
- …to 3:30 PM + **Days:** Monday through Friday The Advanced Inpatient Coding Specialist is a full-time remote position. _Sign on bonuses available!_ Responsibilities: ... + The Medical Records Advanced Inpatient Coding Specialist analyzes the multi day, multi-specialty complex documentation for inpatient encounters to assign… more