- Elevance Health (Indianapolis, IN)
- …based sponsorship. **Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective ... and accurate reimbursement criteria.** PRIMARY DUTIES: + Review medical record documentation in support of Evaluation and Management, CPT, HCPCS and ICD-10 code. +… more
- HCA Healthcare (Nashville, TN)
- …VA). Do you want to join an organization that invests in you as a Senior Appeals Analyst ? At Parallon, you come first. HCA Healthcare has committed up to $300 ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...a difference. We are looking for a dedicated Senior Appeals Analyst like you to be a… more
- Beth Israel Lahey Health (Charlestown, MA)
- …in a high-profile team tasked with handling all commercial and government clinical appeals and audit processes. The Clinical Analyst will perform high-level ... gather information that would support submitted charges. Prepare clinical appeals relevant to the audits in order to prove...* Ability to review and analyze issues related to coding , billing, and medical record documentation. *… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …will be considered. * 3 years of relevant health plan or provider office medical coding /claims and/or Business Analyst experience in a healthcare setting ... Cross and Blue Shield of Minnesota Position Title: Healthcare Coding Analyst Location: Hybrid | Eagan, Minnesota... appeals assuring that federally and state mandated coding rules are followed and that the medical… more
- Stanford Health Care (Palo Alto, CA)
- …as well as excellent analytical and communication skills. The Clinical Government Audit Analyst and Appeals Specialist II will collaborate with clinical staff, ... Denial Analysis: Conduct thorough analyses of denials, evaluating the appropriateness of medical services and procedures. Ensure accurate coding with ICD, HCPCS,… more
- Intermountain Health (Broomfield, CO)
- **Job Description:** The HIM Coding Audit Training Analyst Coordinator provides advanced training to hospital coding staff, compliance, CDI, physicians, and ... subject matter expert for all ICD-10 CM/PCS and CPT coding practices, conventions, regulatory, and reimbursement guidelines for the...compliance and the CDI team. + Audits and creates appeals for all payer and regulatory denials and downgrades… more
- The Cigna Group (Bloomfield, CT)
- …and compliantly execute daily RA program operations, as identified. Participates in coding reviews of medical documentation for RA programs, as needed. ... Adjustment Data Validation audits (RADV), Risk Adjustment operations, Risk Adjustment medical record and diagnosis coding excellence, implementation of Quality… more
- Immigration and Customs Enforcement (Washington, DC)
- Summary The Claims Management Program Analyst supports the Health Plan Management Unit by managing claims, provider recruitment, and compliance with healthcare ... AND RESPONSIBILITIES: Serves in the capacity as a Claims Management Program Analyst ; handles and assists program activities and policies related to claims… more
- Beth Israel Lahey Health (Charlestown, MA)
- …job, you're making a difference in people's lives.** The Revenue Cycle Denial Analyst is charged with coordinating the analysis and effective resolution of denied ... down to the line item detail, identifying payer and coding trends, risks, and opportunities, to implement operational or...be appealed. Responsible for writing timely, comprehensive and compelling appeals to third party payers in order to get… more
- Community Health Systems (Franklin, TN)
- …contract compliance issues and enhance payer relations. + Maintains knowledge of medical coding systems, reimbursement structures, and regulatory changes to ... **Job Summary** The Contract Management Analyst is responsible for maximizing reimbursement by identifying...internal teams and external payer representatives. + Knowledge of medical coding systems (ICD-10, CPT, HCPCS, DRG,… more
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