- Commonwealth Care Alliance (Boston, MA)
- …the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective claims auditing ... and clinical coding and reimbursement edits and necessary coding ...employment - + Certified Professional Coder (CPC) + Certified Inpatient Coder (CIC) + Certified Professional Medical Auditor (CPMA)… more
- Covenant Health Inc. (Knoxville, TN)
- …strongly preferred. Licensure Requirement: None Apply/Share Job Title CLIN REFERRAL SPECIALIST ID 4429128 Facility Covenant Medical Management Department Name ... Overview Clinical Referral Specialist , Centralized Referrals Full Time, 80 Hours Per...The Referral and Precertification Specialists manages scheduling for specialty facilities and procedures, creates and registers new patient charts,… more
- Mount Sinai Health System (Elmhurst, NY)
- **Job Description** Review Medical charts and documentation within but not limited to the facility EMR, Epic, to ensure that all Physician charges are captured in a ... High School Diploma. Knowledge of Medical Terminology, ICD-9CM, ICD-10CM and CPT 4 coding certification obtained by completion of a certificate course with CPC /… more
- University of Virginia (Charlottesville, VA)
- …with the insurance companies, patients and internal customers. Performs inpatient /outpatient billing process for multiple different facility types ... The Central Billing Office (CBO) Insurance Resolution Specialist handles and resolves all Insurance billing follow...billing follow up and denial issues to ensure all facilities within UVA Health System receives correct reimbursements from… more
- UPMC (Pittsburgh, PA)
- …regulations to determine medical necessity or the clinical appropriateness for inpatient admissions, outpatient facility , office services, durable medical ... UPMC Digestive Health Care is hiring a full-time Authorization Specialist to join their team at Shadyside Medical Building, Pittsburgh! In this position, you will… more
- University of Southern California (Los Angeles, CA)
- The Transplant Charge Specialist (TCS) is responsible for the comprehensive review of charges under the transplant program and revenue capture surrounding transplant ... liver, kidney, pancreas, etc.) for commercial, Medicare, hospital-based, provider-based inpatient and outpatient transplant accounts to support appropriate allocation… more
- Hackensack Meridian Health (Red Bank, NJ)
- … inpatient admissions and observations as specified by the facility 's Utilization Management/Review Committee for documentation completeness and compliance with ... and serve as a leader of positive change. The **Clinical Documentation Specialist RN** facilitates improvement in the overall quality, completeness and accuracy of… more
- Bon Secours Mercy Health (Greenville, SC)
- …operational excellence. **Primary Function/General Purpose of Position** The Surgery Scheduling Specialist is responsible for accurately scheduling all inpatient ... scheduled procedures and any changes to the schedule. The surgery scheduling specialist would be responsible for verifying patient benefits and precertification from… more
- Ansible Government Solutions (Memphis, TN)
- …is their own. Responsibilities + Act as the Registered Nurse Advisor for the facility 's CDI program, focusing on both inpatient and outpatient services + Review ... health records concurrently to identify opportunities for improved documentation and coding accuracy using clinical knowledge and critical thinking skills + Support… more
- UPMC (Steubenville, OH)
- …regulations to determine medical necessity or the clinical appropriateness for inpatient admissions, outpatient facility , office services, durable medical ... invite you to join our team as an Authorization Specialist at UPMC Hillman Cancer Center! At UPMC, we...procedures to avoid financial penalties to patient, provider and facility . + 2. Utilizes payor-specific approved criteria or state… more