- Hartford HealthCare (Farmington, CT)
- …and initiate action plans as indicated, report trends and concerns to CDI Manager **Other Management** . Contributes to the efficient operation of the CDI department ... and manages orientation activities for new CDS in collaboration with CDI Manager of Quality and Education. . Establishes and maintains performance expectations of… more
- University of Rochester (Rochester, NY)
- …to federal and state regulations bringing concerns to the attention of billing Manager and Supervisor. The Claim Resolution Rep III will represent the department and ... assigned tasks, following standard procedures as directed by the Supervisor or Manager . **Machines and Equipment Used** : Standard office equipment, including but… more
- Molina Healthcare (Long Beach, CA)
- …state of practice. * Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare ... ensure compliance with National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all… more
- Molina Healthcare (Los Angeles, CA)
- …state of practice. * Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare ... ensure compliance with National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all… more
- CenterWell (Jacksonville, FL)
- …indicators (KPIs), such patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS, meeting local and organizational goals + Personally ... primary care including health promotion & prevention, disease management, effective specialist & hospital co-management, and complex care management + Spend 20-30%… more
- Molina Healthcare (Salt Lake City, UT)
- …**Preferred Qualifications** * Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional ... Procedure Coding (HCPC). * Experience demonstrating knowledge of Centers for Medicare and Medicaid Services (CMS) guidelines, MCG, InterQual or other medically… more
- MyFlorida (Naples, FL)
- …other billing functions. This position reports to the TB PROGRAM MANAGER -NURSING PROGRAM SPECIALIST . Your Specific Responsibilities: Medical Billing: Performs ... clients and representatives from 3rd party insurance companies, Medicaid, and Medicare for the verification of insurance and coverage. Additionally, this position… more
- Molina Healthcare (TX)
- …**Preferred Qualifications** + Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional ... compliance with the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all… more
- ChenMed (Clearwater, FL)
- …opportunities within the CPL. + Responsible for meeting with high volume community specialist at least monthly to give them feedback on their referring trends and ... + Performs other duties as assigned and modified at manager 's discretion. KNOWLEDGE, SKILLS AND ABILITIES: + Advanced-level business...related field is required + Healthcare experience within the Medicare HMO population is a plus + A valid,… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …by current CMS regulations. Work directly with the Medical Coding Auditor Manager to implement best practices to maximize revenue, improve coding accuracy and ... Key Performance Indicator(KPI) requirements as determined by the Medical Coding Auditor Manager + Participate in the development of coding and billing strategies,… more