- LA Care Health Plan (Los Angeles, CA)
- Medical Review Nurse Coder RN III (Payment Integrity Nurse ) Job Category: Clinical Department: Managed Care Services Location: Los Angeles, CA, US, ... to achieve that purpose. Job Summary The Payment Integrity Nurse Coder RN III is responsible for...and reimbursement policies within the claim adjudication process through medical record review for Payment Integrity and… more
- Peak Vista (Colorado Springs, CO)
- Patient Accounts Coder Summary Title:Patient Accounts Coder ID:0430-5133 Department Location:3205/3207 N. Academy, Colorado Springs, CO 80917 ... programs and education. We provide integrated health care services including medical , dental, and behavioral health through our 21 outpatient health centers.… more
- Molina Healthcare (WI)
- …DESCRIPTION** **Job Summary** Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate ... & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years of… more
- Childrens Hospital of The King's Daughters (Chesapeake, VA)
- + GENERAL SUMMARY + The Revenue Integrity Nurse Auditor is responsible for the auditing and compliance functions necessary to effect accurate and complete ... regulations and trends in denials of services due to medical necessity or appropriateness of services. + Conducts compliance,...CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered Nurse holding a valid… more
- CenterWell (Independence, MO)
- …team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse , MA, Behavioral health specialist, Quality based Coder , Referral Coordinator ... care team supporting patient's physical, emotional, and social wellness. The Nurse Practitioner (VSP/PT) applies advanced education and clinical competencies to… more
- CenterWell (Decatur, GA)
- …team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse , MA, Behavioral health specialist, Quality based Coder , Referral Coordinator ... providing a positive and welcoming environment for all. The Nurse Practitioner (NP) or Physician Assistant (PA) works in...accordance with standards of care. . Follows level of medical care and quality for patients and monitors care… more
- CenterWell (Lafayette, LA)
- …team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse , MA, Behavioral health specialist, quality based coder , referral coordinator ... the healthcare industry as a whole. JOB SUMMARY: The Nurse Practitioner (NP) works in our team-based care environment....accordance with standards of care. + Follows level of medical care and quality for patients and monitors care… more
- Molina Healthcare (Long Beach, CA)
- …**Preferred License, Certification, Association** + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialists (CMAS) + Certified ... **JOB DESCRIPTION** **Job Summary** The **Delegation Oversight Nurse ** is responsible for ensuring that Molina Healthcare's UM delegates are compliant with all… more
- Veterans Affairs, Veterans Health Administration (Martinsburg, WV)
- …the Medical Administration Service at the Martinsburg, West Virginia VA Medical Center. The MRT ( Coder ) Clinical Documentation Improvement Specialist (CDIS) ... detailed definition of mastery level certification. OR, Clinical experience, such as Registered Nurse (RN), Medical Doctor (MD), or Doctor of Osteopathy (DO),… more
- CenterWell (Winter Haven, FL)
- …treats center patients in accordance with standards of care. + Follows level of medical care and quality for patients and monitors care using available data and ... limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care. + Acts as...in a timely manner working with a quality- based coder to optimize coding specificity. + Follows policy and… more