- Fairview Health Services (St. Paul, MN)
- …expected reimbursement for services provided by the hospital/physician. Reviews and analyzes medical records and coding guidelines to formulate coding arguments ... coding classification system in accordance with coding rules and regulations. + Reviews medical records for the determination of accurate assignment of all… more
- Centene Corporation (Jefferson City, MO)
- …Ensure compliance with coding practices through a comprehensive review and analysis of medical claims, medical records , claims history, state regulations, ... obligations, corporate policies and procedures, and guidelines established by the American Medical Association and the Centers for Medicare and Medicaid Services. +… more
- Elevance Health (Denver, CO)
- …Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG)** 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
- Ankura (New York, NY)
- …+ Specific experience with RADV Audit responses including managing the collection of medical records , overseeing the selection of records and submitting ... knowledge of Risk Adjustment coding requirements preferably with a Risk Adjustment Coder certification. For individuals assigned and/or hired to work in California,… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …ensuring the accuracy of DRGs. This individual will: + Reviews inpatient medical records for select payer populations post-discharge and pre-bill; audits ... between the Clinical Documentation Specialist (CDS) DRG and the Coder DRG. + Reviews non-CC/MCC records to determine if record was miscoded or if additional… more
- Community Health Systems (Franklin, TN)
- …utilizing appropriate coding references for CHS hospitals via scanned, electronic and hybrid medical records . Based on review findings, writes appeal letters to ... audits for both RAC and non-RAC accounts, reviewing patient records for accuracy in ICD-10-CM/PCS coding, DRG assignments, and...Appeals. + Partners with peers and Director to develop coder education based on findings. + Performs other duties… more
- Bon Secours Mercy Health (Greenville, SC)
- …Heart Association required BAT, DOT Urine Drug Screen, PFT, Hearing Conservation, Medical Coder preferred **Education** High School Diploma required Associates ... + Responsible for coordination of care (scheduling, testing, reporting) and obtaining records for patients referred to a specialist, diagnostics, therapy, etc. +… more
- Elevance Health (Chicago, IL)
- …abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new healthcare-related questions as ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Fraud Investigator II** is responsible for… more
- Bozeman Health (Bozeman, MT)
- …compliance with applicable laws, regulations, payer rules, and internal policies. + Reviews medical and billing records for coding accuracy and medical ... for compliance. + Intermediate knowledge and experience with electronic health records (EHR) systems (preferably Epic) and compliance/audit management tools. +… more
- Mount Sinai Health System (New York, NY)
- …cycle environment. ? Extensive knowledge of medical billing software and electronic medical records . Must have experience working with Epic. ? Knowledge of ... Technologist and related professions). ? Certifications such as Certified Professional Medical Auditor (CPMA), Certified Inpatient Coder (CIC), Certified Coding… more
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