- St. Luke's University Health Network (Allentown, PA)
- …collaboration with the Claim Editing Manager, Physician, Specialty Coder, AR specialist or Auditor /Educator. Demonstrate the ability to formulate an appeal ... a patient's ability to pay for health care. The Claim and Denial Coding Analyst role is a Certified...role is a Certified Medical Coder who ensures clean claim submission and timely review and resolution of coding… more
- Robert Half Accountemps (Los Angeles, CA)
- …and finalizing DNB edits either in the PFS host Patient Accounting system or claims editing system. At times, the Chart Auditor may conduct insurance audits ... in Los Angeles is in the need of Chart Auditor . The Chart Auditor is responsible for...issues. + Consistently and thoroughly work DNFB and PFS claim edits work lists to ensure timely completion within… more
- Highmark Health (Jefferson City, MO)
- …and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting ... or Outpatient): Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) + AAPC Credentials (Outpatient): Certified Professional Coder… more
- Hackensack Meridian Health (Hackensack, NJ)
- …as a leader of positive change. The **Diagnosis Related Group (DRG) Auditor ** is responsible for auditing clinical documentation that supports code assignment for ... includes compliance with the Conditions of Participation for CMS. The DRG auditor is responsible for ensuring coding accuracy, coding consistency and efficiency in… more
- Trinity Health (Mason City, IA)
- …inpatient, ER, outpatient hospital visits, and lab requisitions. The clinic coding specialist will also be responsible for communicating with providers if their ... the code selection. + Assures codes reported to the claim are supported in the medical record documentation for...Works with the Coding Supervisor and /or Clinic Coding Auditor /Educator to resolve any on-going issues with provider documentation… more
- Chevron Phillips Chemical (The Woodlands, TX)
- …**Purpose/Introduction (continued)** We are seeking an **Operational Excellence Reviews Specialist ** at our headquarters in The Woodlands, Texas. The successful ... analyses + Plans, facilitates, and participates in instructor-led Guest Reviewer/ Auditor training classes + Assists in review and development...fee will be paid for candidates who apply and claim to be represented by an agency. Any unsolicited… more
- Dentsply Sirona (York, PA)
- …-by helping improve oral health worldwide. **Scope** The Technical Support Specialist works directly with our customers, assisting with technical aspects of ... Company policies + All other duties assigned. **Technical Support Specialist I** + Work with other Dentsply Sirona SBU's...SBU's to complete VCR's and create RMA's for warranty claims . + Maintain daily interactions with shipping, accounting and… more
- Sedgwick (Columbus, OH)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer IT Compliance Specialist Sr, GRC **PRIMARY PURPOSE** **:** To advance the IT Compliance ... + At least one of the following credentials preferred: Certified Internal Auditor (CIA), Certified Information System Security Professional (SSCP), Certified in Risk… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Inpatient Hospital Rates Specialist ** **Job Class: Human Services Program Consultant** **Agency: Human Services Dept** + **Job ID** : 77097 + ... ensure that rate setting calculations are correctly programmed into the claims payment system. **Minimum Qualifications** Three (3) years of specialized professional… more
- Immigration and Customs Enforcement (IN)
- …to billing, coding, and utilization/case management [e.g., MCG Care Guideline Specialist , Certified Professional Medical Auditor (CPMA), or Certified Inpatient ... Authorization Requests (MedPARs) for select reimbursable health care services, medical claims review, and utilization review. Provides coverage for other Utilization… more