- Geisinger (Danville, PA)
- …Reviews the content of the medical record for hospital and professional inpatient or outpatient records to identify principal diagnosis, secondary diagnoses and ... severity and comply with standard provider coding regulations. + Carefully details review of documents such as laboratory findings, radiology reports, various scan… more
- Molina Healthcare (Buffalo, NY)
- …**E** **N** **C** **E:** + Min. 6 years' experience in healthcare claims review and/or member dispute resolution. + 2 years leadership experience + Experience ... reviewing all types of medical claims (eg HCFA 1500, Outpatient/ Inpatient UB92, Universal Claims, Stop Loss, Surgery, Anesthesia, high dollar complicated claims, COB… more
- Avera (Sioux Falls, SD)
- …management departments and billing offices with ICD-10, CPT, and HCPCS coding review , DRG and APC reimbursement, and coordination of information between ... American Health Information Management Association (AHIMA) Upon Hire or + Certified Inpatient Coder (CIC) - American Academy of Professional Coders (AAPC) Upon Hire… more
- Molina Healthcare (Kenosha, WI)
- …experience. **Required Experience** * 7 years experience in healthcare claims review and/or member appeals and grievance processing/resolution, including 2 years in ... Experience reviewing all types of medical claims (eg HCFA 1500, Outpatient/ Inpatient UB92, Universal Claims, Stop Loss, Surgery, Anesthesia, high dollar complicated… more
- Carle Health (Champaign, IL)
- …system and all Carle physician groups. Oversee all aspects of inpatient , outpatient and professional coding operations, clinical documentation, coding audit and ... processes. + Thorough understanding of codes sets, including ICD10, DRG , HCPCS, CPT, E/M, RVUs, LCDs and NCDS. +...coding practices and guidelines followed. + Oversees the development, review and revision of department policies and procedures. +… more
- Kaleida Health (Buffalo, NY)
- …is responsible for coding, including, but not limited to any type of inpatient /or outpatient medical records for the purpose of data quality, accurate reimbursement, ... and state regulations. Diagnoses and procedures are coded through review of the entire medical record, utilizing the International...in coding with ICD 10, PCS, CPT Coding and DRG /APC assignment in an acute care facility preferred. Prior… more
- Molina Healthcare (Columbus, OH)
- …**PE** **R** **I** **E** **N** **C** **E:** + 5 years experience in claims review and member and provider appeal resolution. + Experience reviewing all types of ... medical claims (eg HCFA 1500, Outpatient/ Inpatient UB92, Universal Claims, Stop Loss, Surgery, Anesthesia, high...Loss, Surgery, Anesthesia, high dollar complicated claims, COB and DRG /RCC pricing). + Previous experience leading projects or lead… more
- HCA Healthcare (Orange Park, FL)
- …analysis, and completion of diagnoses working with medical coders to include CPT and DRG / ICD codes based on stroke and other Neurosciences selected diagnoses. The ... from preadmission, through the medical management and/or surgery process, inpatient stay, post-operative/discharge follow-up care, and readmission prevention to… more
- Ansible Government Solutions (Memphis, TN)
- …the Registered Nurse Advisor for the facility's CDI program, focusing on both inpatient and outpatient services + Review health records concurrently to identify ... Clinical Documentation Integrity Specialists (ACDIS) + Knowledge of ICD-10-CM and MS- DRG coding systems + Experience with electronic health record systems,… more