- Houston Methodist (Houston, TX)
- …denials, denial reason and trending, interpretation of payer manuals, medical policies, and local/national coverage determinations. **SERVICE ESSENTIAL FUNCTIONS** + ... are needed. **QUALITY/SAFETY ESSENTIAL FUNCTIONS** + Analyzes data from various sources ( medical records, claims data, payer medical policies, etc.), determines… more
- Sharecare (Boston, MA)
- …Radiology Technician + Home Health Aide + Occupational Therapist Aide + Medical Coder + Dental Assistant + Experience in customer service in a healthcare ... the leading digital health company that helps people - no matter where they are in their health journey...utilization management (UM) status, including but not limited to medical , dental, and vision plans + Provider search (PCP,… more
- CenterWell (Spartanburg, SC)
- …medicine, continuity of care, health maintenance, and disease prevention. Keeps a medical history and medical records. Refers the patient to specialists ... accordance with standards of care. + Follows level of medical care and quality for patients and monitors care...in a timely manner working with a quality- based coder to optimize coding specificity. + Follows policy and… more
- Elevance Health (Richmond, VA)
- …and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient Coder . + Requires 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **DRG CODING AUDITOR** is responsible for auditing… more
- Stony Brook University (Commack, NY)
- …education training for new employees. + Assess and provide feedback to each coder on their work performed. + Development of reinforcement training for existing staff ... performance + Perform coding audits and validation by reviewing medical records for correct ICD-10-CM and ICD-10 PCS coding....(HIM) or related field. At least 6 years of experience with ICD-10 CM and ICD-10 PCS coding. RHIA,RHIT,… more
- Novant Health (Bolivia, NC)
- …Education: High School Diploma or GED, required. + Experience : Three years of experience in a medical office setting, required. Other related experience ... charges drop for claims processing. Works closely with practice coder in resolution process. Responds to requests from practice...be considered in lieu of medical office experience . + Additional Skills (required): Knowledge of medical… more
- CVS Health (Hartford, CT)
- … terminology/CPT/HCPCS coding. - Advanced skills with Microsoft Excel - Experience in healthcare/ medical insurance claims investigation or professional/clinical ... proceedings or training if necessary **Required Qualifications** - 1-3 years of Investigative experience in the area of healthcare fraud, waste and abuse - Strong… more
- CenterWell (Spartanburg, SC)
- …referral coordinators and more. Our approach allows us to provide an unmatched experience for seniors. Our model is positioned to provide higher quality care and ... better outcomes for seniors by providing a concierge experience , multidisciplinary services, coordinated care supported by analytics and tools, and deep community… more
- Elevance Health (Hanover, MD)
- …Related Group Clinical Validation Auditor** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs ... you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of … more
- Walmart (Bentonville, AR)
- …from days to minutes. We're looking for a creative and technically sharp Vibe Coder to push for an AI-first development team. In this role, you'll collaborate with ... a related field. Master's degree is a plus. . Experience with AI-assisted coding tools (eg, ChatGPT, Copilot). ....a happier mind, body, and wallet. Health benefits include medical , vision and dental coverage. Financial benefits include 401(k),… more