- 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 ... and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction. Review medical records for completeness, accuracy and...a minimum of 5+ years' experience in Health Insurance/quality chart audits and/or Utilization Review Bachelor's degree… more
- Spectraforce Technologies Inc (Atlanta, GA)
- …working in a remote setting Education/Experience RN or LPN/LVN license HEDIS Medical Record Review experience preferably within the last 5 years Computer ... of the HEDIS Clinical Measurement and Improvement Lead and other Company personnel to review medical records. The HEDIS Nurse Abstractor will abstract pertinent … more
- Careers Integrated Resources Inc (Atlanta, GA)
- …. 2 years clinical practice experience . 1 year experience in clinical auditing or medical review preferred . Knowledge of clinical data auditing or HHS risk ... Job Title: Risk Adjustment Clinical Reviewer Location: 100% Remote Duration: 2 Months (Possible Extension) This is...and health insurance databases . Work Experience: Experience performing chart audits and review preferred. Coding experience… more
- Careers Integrated Resources Inc (Atlanta, GA)
- …Can understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction. Review medical records for completeness, accuracy and compliance with applicable ... Review may include inpatient, outpatient treatment and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment… more
- Fresenius Medical Center (Plano, TX)
- …Excel skills + Requires excellent analytical skills and critical thinking skills + Chart review experience required + Auditing experience required + AAPC or ... and claims processing and identifying and resolving problems that lead to medical claim denials. The Coder provides administrative support in the interpretation and… more
- Tidelands Health (Murrells Inlet, SC)
- …as set forth by AHIMA. Abstracting required clinical information from the medical record. Queries physicians as needed, to clarify documentation to ensure accurate ... reviews, and data collection. + Reviews all documentation from Qualified Medical Providers (QMPs) to assign all significant diagnoses. Additionally, all… more
- VNS Health (Manhattan, NY)
- …key quality metrics are noted on claim, as provided during the encounter. Performs medical chart reviews to validate codes for quality monitoring, reporting, and ... We are seeking a skilled Home Coding Specialist to review and audit claims, ensuring they meet all billing,...review findings, outcomes, and issues. + Engages with medical practitioners to provide feedback and educational resources on… more
- Dignity Health (Merced, CA)
- …ICD10 Coding in relation to DRGs + Abstract additional data elements during the chart review process when coding as needed + Utilize technical coding principals ... State of California. Please check our website (https://www.commonspirit.careers/search-jobs) (Search Category: Medical Coding) for other remote or non- remote … more
- Tufts Medicine (Burlington, MA)
- …specific clinical and demographic data from the patient record. 2. Performs pre-visit chart audits, and post encounter review to ensure coding accuracy and ... **Hours:** 40 hours per week - Monday through Friday. **Location:** 100% Remote **Job Profile** **Summary** This role focuses on activities related to revenue cycle… more
- University of Miami (Miami, FL)
- …or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Up to ... Miami Hospital + This is an onsite position. Not remote . + Provides for patients' personal hygiene by giving...100%, using hospital designated scripting. + Maintains the patient's chart in appropriate order. + Initiates and assembles admission… more
- AdventHealth (Altamonte Springs, FL)
- …understanding that **together** we are even better. **Job Location** : **Monday-Friday** ** Remote ** **The role you'll contribute:** The Coder Analyst IV is a Health ... for the Multi-State Division. Will work and resolve the chart correction issues daily and work with the team...Coder Analyst IV may participate in our quality, safety review process, which includes mortality, PSI, and HAC reviews.… more
- CVS Health (Tallahassee, FL)
- …who prepare and review Applied Behavior Analysis (ABA) service provision for medical necessity. + Reviews and prepares cases for medical necessity review ... our members with neurodevelopmental disorders across the organization. This position is fully remote . Fully remote . Eligible candidates can live anywhere in the… more
- University of Miami (Miami, FL)
- …System, Department of Utilization Management, has an exciting opportunity for an Utilization Review Case Manager to work remote . The incumbent conducts initial, ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of… more
- AdventHealth (Daytona Beach, FL)
- …we are even better. **Schedule:** Full Time **Location: AdventHealth Daytona Beach** **100% Remote ** 301 Memorial Medical Parkway Daytona Beach, FL 32117 **The ... **Coding Specialist** ** Remote !** **All the benefits and perks you need...role you'll contribute:** Performs a thorough review , assessment and analysis of the inpatient … more
- Kepro (AR)
- …of supervision. Responsibilities include, but are not limited to + Review first-level Prior Authorization (PA) requests related to handicapping malocclusions, ... + Acentra Health is responsible for all levels of review : + First-level reviews will be completed by a...codes and generally accepted clinical and adjudication guidelines on medical necessity of proposed dental procedures. Ability to examine… more
- Houston Methodist (Houston, TX)
- …caring for adults in an acute care hospital setting is required; coding and utilization review experience preferred + For Medical School graduate - One year of ... quality and completeness of clinical documentation. This position analyzes medical records for DRG's, complications, and comorbidities; identifies trends; and… more
- Molina Healthcare (Florence, KY)
- …collection, reporting and monitoring process, including HEDIS, state-based measure reporting and medical record review . + Manages annual HEDIS data collection ... is performed for generated reports including performance measurement rates. + Manages medical record review and performance measurement reporting projects for… more
- Fairview Health Services (St. Paul, MN)
- …treatment authorization requests and pursues referrals per payor guidelines. + Reviews medical chart /history and physician order(s) to determine likely ICD and ... Referrals and/or prior authorization experience + Epic experience + Knowledge of medical terminology and clinical documentation review **EEO Statement** EEO/AA… more
- AdventHealth (Orlando, FL)
- …in the management of resources entrusted to them. + Reviews concurrent medical record for compliance including completeness and accuracy for severity of illness ... of mortality (ROM) and quality. + Completes accurate and timely record review to ensure the integrity of documentation compliance. Completes accurate and concise… more
- Fallon Health (Worcester, MA)
- …The RAA will own the claims adjustment workflow associated with regulatory retrospective chart review efforts. The RAA will have shared ownership within the ... risk scores over time and to improve revenue accuracy. The RAA will review and apply all related regulatory requirements to department activities, ie audits, changes… more
