- Elevance Health (Mason, OH)
- ** Clinical Documentation and Claims Integrity Director** **Location:** **Virtual:** This role enables associates to work virtually full-time, with the ... through home-care and community based services. **The Clinical Documentation and Claims Integrity Director** will lead CareBridge's efforts in diagnostic… more
- Insight Global (Beachwood, OH)
- …Perform site visits, oversee test article reconciliation and disposition, and maintain accurate documentation . - Data Integrity & Reporting o Ensure the accurate ... o Resolve case report discrepancies and ensure completeness and integrity of clinical records. o Author or...to scientific manuscripts, conference presentations, and publications. o Provide clinical evidence to support marketing claims and… more
- Molina Healthcare (Akron, OH)
- …with appeals, claims review, and medical coding. **Job Summary** Utilizing clinical knowledge and experience, responsible for review of documentation to ... + Performs clinical /medical reviews of retrospective medical claim reviews, medical claims and previously denied cases, in which an appeal has been submitted, to… more
- Medical Mutual of Ohio (OH)
- …operations. + Ability to utilize certified HEDIS software. + Ability to analyze clinical , claims , pharmacy, encounter, and quality measurement data. + Advanced ... Tableau. + Ability to utilize certified HEDIS software. + Ability to analyze clinical , claims , pharmacy, encounter, and quality measurement data. + Advanced… more
- Banner Health (OH)
- …patient care. POSITION SUMMARY This position is responsible for the interpretation of clinical documentation completed by the health care team for the health ... record(s) and for quality assurance in the alignment of clinical documentation and billing codes. Works with...findings. 4. Acts as a knowledge resource to ancillary clinical departments, patient financial services and revenue integrity… more
- Elevance Health (Mason, OH)
- …for all lines of business, and its clients. Also responsible for performing clinical reviews of medical records and other documentation to evaluate issues ... accommodation is granted as required by law._ Carelon Payment Integrity is a proud member of the Elevance Health...you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical… more
- Evolent (Columbus, OH)
- …risk adjustment coding team and operations, ensuring accurate and timely ICD-10 coding of claims via progress note clinical documentation review. + Ensure ... and that impact the team. Provide individual and team training on clinical documentation requirements, risk adjustment coding guidelines, and updates. +… more
- Elevance Health (Mason, OH)
- …employment, unless 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...medical-expense spending. The Manager of DRG Coding Audit & Clinical Validation leads a high-performing team responsible for auditing… more
- Bon Secours Mercy Health (North Ridgeville, OH)
- …effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. **Are you passionate** **about** **contributing to** ... associates dedicated to each other and to providing exceptional clinical care and patient experiences. **Connected** : We are...work quickly and safely + Helps complete worker's compensation claims + Reduces the risk of future issues +… more
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