- Excellus BlueCross BlueShield (Rochester, NY)
- …Adjustment Data Validation (RADV) Audits Essential Accountabilities: Level I * Reviews medical records to determine if specific disease conditions were correctly ... record coding. * Works with vendors, providers and hospital Medical Records Departments and Business Office staff...to Level I Minimum Qualifications) * Minimum of two ( 2 ) years coding experience or directly related medical… more
- Billings Clinic (Billings, MT)
- …Within 2 years of hire * Certified Documentation Improvement Practitioner (CDIP), Within 2 years of hire * Certified Professional Coder (CPC), Within 2 ... all full- and part-time employees (minimum of 20 hours/week), including Medical , Dental, Vision, 403(b) Retirement Plan with employer matching, Defined Contribution… more
- Penn Medicine (Philadelphia, PA)
- …degree. (Required) + 4+ years of experience coding and auditing inpatient and outpatient medical records . (Required) + 2 + years of supervisory or management ... the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and...Services Department - Central Fee Abstract Corp Location - 2 Bala Plaza Hours - M-F, 8 hr days,… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …billing errors, coding discrepancies, and policy non-compliance. Audits include reviewing medical records , applying clinical and coding knowledge, analyzing ... contractual, coding, payment policy, and regulatory standards. + Review itemized bills, medical records , and other claim documentation to verify coding accuracy… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …and Resident]. Your Day to Day: Preform post pay audits on hospital bills and medical records to assure all services and charges are supported by clinical ... BS/BA Degree or comparable work experience + Active certified coder (RHIA, RHIT, CCS-P, CCS, and/or CPC) required; CPMA,...CPT, HCPCS, and ICD-10-CM + Working knowledge of electronic medical records systems + Ability to work… more
- Hartford HealthCare (Bridgeport, CT)
- …of the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI). * Reviews medical records to assure that clinical documentation supports FIM ... to assist in resolution of any inconsistencies. * Reviews medical records and confers with medical...IRF-PAI. Makes any necessary changes in collaboration with the coder and physician. * Based on medical … more
- Stanford Health Care (Palo Alto, CA)
- …and comprehensive appeal letters to payors after a detailed review of medical records . Ensure compliance with Medicare, Medicaid, third-party guidelines, Local ... Denial Analysis: Conduct thorough analyses of denials, evaluating the appropriateness of medical services and procedures. Ensure accurate coding with ICD, HCPCS, CPT… 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 ... for coordination of care (scheduling, testing, reporting) and obtaining records for patients referred to a specialist, diagnostics, therapy,...Degree preferred **Work Experience** 2 years of experience in industry or an office… 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 ... SIU** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to… more
- CenterWell (Greenville, SC)
- …Doctors, Advanced Practice Professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health Specialists, Quality Based Coders, Referral Coordinators ... 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