- Stanford Health Care (Palo Alto, CA)
- … Coding Initiative (NCCI) and payer specific edits related to hospital and professional coding . The Single Path Coder processes codes for surgical encounters ... Coding Specialist II serves as a subject matter expert in hospital and professional coding , and interacts with other teams and departments across the… more
- Stanford Health Care (Palo Alto, CA)
- …lead to appropriate execution of regulatory requirements and guidelines related to professional or facility and documentation, charging, coding and billing, ... requested. + Collaborates with RI CDM to optimize the integrity of the Chargemaster + Applies consistent and standardized...to medical records + Knowledge of ICD-10-CM & CPT coding conventions to code medical record entries; abstract information… more
- Humana (Sacramento, CA)
- **Become a part of our caring community and help us put health first** The Payment Integrity Coding Professional within Code Edit Vendor Management ... of situations or data requires an in-depth evaluation of variable factors. The Payment Integrity Coding Professional monitors and analyzes Code Edit… more
- LA Care Health Plan (Los Angeles, CA)
- …and individual provider coding practices. Responsible for training and mentoring Payment Integrity Nurse Coder, RN staff. Supports the creation and execution ... Payment Integrity Nurse Coder RN III...coding elements. Audits can include inpatient, outpatient, and professional claims. Serves cross functionally with Utilization Management, Medical… more
- Elevance Health (Costa Mesa, CA)
- **DRG Coding Auditor Principal** **_Virtual: _** _ _ This...an accommodation is granted as required by law._ Carelon Payment Integrity is a proud member of ... the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity , is determined to recover, eliminate and prevent unnecessary… more
- Highmark Health (Sacramento, CA)
- …consistent with established industry and corporate standards and are within the Payment Integrity Clinician's professional discipline.Effectively function in ... The incumbent is responsible for the implementation of effective Payment Integrity strategies on a pre- payment...coding criteria, as well as other approved guidelines, payment and medical policies.Promote quality and efficiency in the… more
- University of Southern California (Alhambra, CA)
- …Coding Clinic, and CPT Assistant to maintain knowledge of the principles of coding . * Keep up-to-date and reviews other professional journals and newsletters ... In accordance with current federal & state coding compliance regulations and guidelines, the HIM ...rejection to honor Keck Medicine of USC request for payment for both IP & OP healthcare services provided… more
- Sharp HealthCare (San Diego, CA)
- …Qualifications** + 2 years' experience with hospital and ambulatory care charging and coding practices, contractual payment schemes. + 1 year auditing and/or ... Problem ResolutionReviews and follows-up on issues in assigned Epic Revenue Integrity work-queues.Follows-up with clinical, coding , billing and operational… more
- Humana (Sacramento, CA)
- …claims initially paid correctly in the system) + Minimum of 2 years Provider Payment Integrity (formally known as Financial Recovery) experience + CAS claims ... to gather knowledge on Medicare Advantage and Medicaid State Regulations + Certified Professional Coding (AAPC) + Previous experience working with the internal… more
- Providence (CA)
- …Schedule:** Full time **Job Shift:** Multiple shifts available **Career Track:** Business Professional **Department:** 5018 COMPLI PAYMENT INTEGRITY OR ... investigation and correction of fraudulent and/or abusive billing and coding practices; coordination of recovery of overpayments related to fraudulent… more
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