- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …ensure the most efficient use of resources, improve clinical outcomes, reduce medical expense, and meet stakeholder demands while supporting high-risk and high-cost ... This position is eligible for the Flex personaKey Responsibilities + Conduct Medical and Cost Assessments on high-cost cases, perform analysis and make… more
- State of Montana (Helena, MT)
- …and Healthy Montana Kids (HMK) programs. Key duties include analyzing medical claims data, evaluating provider billing practices, and ensuring compliance with ... *Qualifications for this Career Opportunity ** * Knowledge of Medicaid rules, medical claims processing, medical terminology and coding principles and practices.… more
- MedKoder (Mandeville, LA)
- About Us MedKoder, LLC is a full-service medical coding management services provider based in Mandeville, Louisiana, specializing in expert medical coding for ... physician documentation that supports codes selected including adherence to Medical Necessity; + Adherence to Local Coverage Determination (LCDs),... Coding Industry Leaders - CEO is a Certified Coder with 20+ years of experience * Up to… more
- Fairview Health Services (St. Paul, MN)
- …reimbursement for services provided by the hospital/physician. Reviews and analyzes medical records and coding guidelines to formulate coding arguments for appeals ... and stays abreast of ICD-10-CM and ICD-10-PCS, coding principles, medical terminology, governmental regulations, protocols and third-party payer requirements… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Coding Specialist, Centralized Coding, Intpatient Coder Full Time, 80 Hours Per Pay Period, Day Shift inpatient Covenant Health Overview: Covenant Health is ... network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area's fastest-growing physician practice division. Headquartered in… more
- Banner Health (Tucson, AZ)
- …Incentive Program as part of your Total Rewards package. Banner University Medical Group is our nonprofit faculty practice plan associated with the University ... primary and specialty care to patients at highly ranked Banner - University Medical Centers and dozens of clinics while providing mentorship to more than 1,200… more
- CenterWell (Anderson, SC)
- …treats center patients in accordance with standards of care. + Follows level of medical care and quality for patients and monitors care using available data and ... limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care. + Acts as...in a timely manner working with a quality- based coder to optimize coding specificity. + Follows policy and… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …AHRQ technical specification and CMS reported HAC's with assistance of the Medical Director of Clinical * Documentation Improvement and Physician Liaisons * Maintain ... monthly PSI/HAC data to CDI and Inpatient Coding Manager, CDI Supervisor, Medical Director of Clinical Documentation Improvement and other departments and leadership… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …to any HHS and CMS RADV audits, including retrieval and coding of targeted medical records. * Design and implement QA programs to improve coding accuracy, reduce ... staff, on proper coding practices and compliance requirements. * Manage medical coding metrics, performance improvement opportunities, and evaluation of in-home… more
- Elevance Health (Indianapolis, IN)
- …Related Group Clinical Validation Auditor-RN** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and ... you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of … more