- Careers Integrated Resources Inc (Atlanta, GA)
- …a minimum of 95% accuracy on coding quality audits. Responsibilities: Compile chart review findings statistics, analyze data results and implement meaningful ... Coding experience Requires a minimum of 5+ years' experience in Health Insurance/quality chart audits and/or Utilization Review Bachelor's degree required more
- Careers Integrated Resources Inc (Atlanta, GA)
- …Coding experience Requires a minimum of 2 years' experience in Health Insurance/quality chart audits and/or Utilization Review Bachelor's degree preferred ... accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment and/or professional medical… more
- Careers Integrated Resources Inc (New York, NY)
- …to function as administrative and technical support of the annual Medical Record Review project required to report HEDIS/QARR measures to the NYS Department of ... Health and Centers for Medicare & Medicaid Services (CMS). The role is field-based...of Role & Responsibilities: Maintain knowledge of medical record review and EMR systems. Proficiency in MS Office applications,… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …and cost in planning and delivering patient care. Participates in peer chart review and other Quality Assessment/Performance Improvement activities as directed. ... perspective and utilizing hospice philosophy of care. Understands hospice Medicare /Medicaid/payor benefits and delivers care in accordance with benefit and… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …and cost in planning and delivering patient care. Participates in peer chart review and other Quality Assessment/Performance Improvement activities as directed. ... perspective and utilizing hospice philosophy of care. Understands hospice Medicare /Medicaid/payor benefits and delivers care in accordance with benefit and… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …and cost in planning and delivering patient care. Participates in peer chart review and other Quality Assessment/Performance Improvement activities as directed. ... perspective and utilizing hospice philosophy of care. Understands hospice Medicare /Medicaid/payor benefits and delivers care in accordance with benefit and… more
- Fallon Health (Worcester, MA)
- …at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. **Responsibilities** The Chart Review Specialist primary responsibility is to review , ... charts for the purpose of validating regulatory Risk Adjustment scores. The Chart Review Specialist will collect diagnostic details and documentation… more
- Actalent (Mcallen, TX)
- …medical record, quality improvement, medical, medical terminology, audit, health care, data, medicare , chart review , ncqa, insurance, data entry, microsoft ... calls, support Top Skills Details: HEDIS,medical record,quality improvement,medical,medical terminology,audit,health care,data, medicare , chart review ,ncqa Additional Skills &… more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- …in state health care facilities for purposes of maximizing reimbursement revenue via Medicare Part B programs; + May review medical records and compile ... Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment #...care providers; + May supervise and participate in hospital Medicare and Medicaid reimbursement programs including preparation of appeals… more
- Billings Clinic (Billings, MT)
- …/ Management RN. This position is to conduct initial, concurrent, retrospective chart review for clinical financial resource utilization. Coordinates with ... for new admissions, within 24 hours Ensure order in chart coincides with the payer review , CMS...Noncoverage (HINN), Condition Code 44, and Important Message from Medicare (IMM). Follows department procedures and policies for Condition… more
- CommonSpirit Health Mountain Region (Durango, CO)
- …leaders who care about your success. Assist with training and coordinating clinical review and quality assurance. Lead and review the appropriateness of clinical ... care and documentation practices related to patients/residents. Review and evaluate quality data to determine areas needing improvement. Review patient… more
- HonorHealth (Scottsdale, AZ)
- …Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of health care services ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- State of Maine, Bureau of Human Resources (ME)
- MaineCare Quality Review Nurse Maine, USA | Nursing | Full-time Apply by: Sept. 20, 2024 Apply with Linkedin Apply Department of Health and Human Services ... this position, please contact Sue Pinette, Asst. Director, Division Medicaid/ Medicare Services at ### or by e-mail at ###@maine.gov....- $12,514.32 annual value), depending on salary. Use this chart to find the premium costs for you and… more
- Sharp HealthCare (Coronado, CA)
- …coverage through MCA for SRS/SCMG and MPV (or Portal) for potential Medicare or Medi-Cal.Use Coordination of Benefits (COB) standards to prioritize billing order ... of insurance plans. Medicare patients - Medicare Secondary Payer (MSP)...medical records and facilitate transfers from/to outside facilities.Create patient chart for physician and organize charts for the HIM… more
- Bassett Healthcare (South Kortright, NY)
- …functions, and or provides orientation as requested by supervisors for new employees. Patient Flow/ Chart Review Performs chart review in preparation for ... arrival prior to patient appointment as measured by supervisory observation. Based on chart review , ensures all necessary equipment and supplies are available… more
- Medical Mutual of Ohio (OH)
- …+ **Applies clinical expertise to collect HEDIS and/or study data through chart review and abstraction.** + **Prepares narratives, reports, graphs, charts, ... insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Applies process… more
- The Cigna Group (Chattanooga, TN)
- …Rely upon independent judgment and decision-making at provider sites, whether conducting chart review or providing training/education, both for historical and/or ... the Risk Adjustment program to ensure correct coding and documentation. + Conduct chart reviews for providers and review provider performance. This is… more
- The Mount Sinai Health System (New York, NY)
- …registered; Completes the central log assuring all fields are complete + Completes Medicare Payor Questionnaire for all Medicare patients + Collects visit fees ... Patient Registration log + Makes appropriate copies of complete chart and stores in dedicated locations + Disburses ... + Gives attending physician walk out charts for review twice daily + ALTERNATING WEEKEND REQUIRED + SOME… more
- St. Luke's University Health Network (Hamburg, PA)
- …education of network policy on Patient Identification including Mark for Merge, Chart Corrections, and Patient Look-Up. + Responsible for the patient registration ... related to registration. Can require contacting provider office, reviewing patient medical chart for diagnosis and medical necessity information. + Required to cross… more
- Aston Carter (Stockton, CA)
- …charges, payments, adjustments, and any follow-up necessary for Self-Pay, Medi Cal, Medicare , and third-party payers. . Reviews patient chart documentation to ... to determine billable services based on payer. guidelines that include Medi-Cal, Medicare , Commercial, and State Specialty Programs. . Evaluate the accuracy of… more
