- University of Miami (Hialeah, FL)
- …review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Concurrent Quality Reviewer of our hospital ... reviews documentation in the electronic medical record (EMR) and ensures that accurate assignment and...CDIs, Coders, Quality, and other relevant multidisciplinary teams. The concurrent inpatient quality reviewer will assign a… more
- Atlantic Health System (Summit, NJ)
- …information from patient records, to accurately reflect the patient's encounter. *Reviews CDI concurrent review notes in 3M360 and works with the CDI Team ... to ensure optimal code capture on all cases. Ensures optimal reimbursement in...reimbursement reporting requirements *Works with their assigned Lead to review coding questions and engage in coder … more
- Trinity Health (Boise, ID)
- …transition needs. Reassesses, monitors, and modifies transition needs as appropriate. Conducts concurrent medical record review using established medical ... of care. **GENERAL SUMMARY AND PURPOSE:** Provides hospital case management/utilization review and discharge planning collaboratively determining level of care needs… more
- Queen's Health System (Honolulu, HI)
- …and completeness of clinical documentation throughout The Queen's Health Systems, through concurrent medical records reviews and query process. * Responsible for ... the concurrent review of provider documentation to ensure...team to ensure integrity and completeness of documentation and code assignment for the purposes of appropriate reimbursement, risk… more
- Fallon Health (Worcester, MA)
- … records for accuracy of coding, ambiguous, conflicting or incomplete documentation. * Conducts concurrent review of the medical records to increase the ... the overall improvement of the quality, completeness and accuracy of medical record documentation through interaction with physicians and other business partners.… more
- Kaleida Health (Buffalo, NY)
- …the clinical documentation. Facilitate modifications to clinical documentation through concurrent interaction with physicians/clinical staff, Medical Directors, ... **Clinical Documentation Specialist Outpatient** **Location:** Buffalo General Medical Center Location of Job: US:NY:Buffalo Work Type: Full-Time **Shift:** Shift 1… more
- Kaleida Health (Buffalo, NY)
- …the clinical documentation. Facilitate modifications to clinical documentation through concurrent interaction with physicians/clinical staff, Medical Directors, ... Description:** The Outpatient Clinical Documentation Specialist (CDS) will perform concurrent and retrospective compliance reviews of the coding and documentation… more
- Dartmouth Health (Keene, NH)
- …Clinical Documentation. The PA supports Utilization Management by performing concurrent , evidence-based second-level medical necessity reviews, educating ... on medical necessity for inpatient/outpatient services, reviewing Medicare Condition Code 44 downgrades, Medicare Outliers for medical necessity, metrics on… more
- Covenant Health Inc. (Knoxville, TN)
- …the validity and reliability of the case-mix index, CDI is accountable for concurrent review of health records, reviewing documentation that supports the ... reviews in the setting of an acute care facility. Concurrent reviews assure the completeness of medical ...to help link ICD-10-CM and ICD-10-PCS coding guidelines and medical terminology to improve accuracy of final Code… more
- GE Vernova (Schenectady, NY)
- …Technical Director, Generation Products & Services team with focus on Grid Code Testing, within the Consulting Services organization, working across several other ... development of GE product/service offerings and support New Product/Technology Introductions concurrent with GE business needs. + Support domestic and global… more
- State of Colorado (Pueblo, CO)
- …delegated by the team within scope. C. Remain with the patient and yell for help/ medical emergency/ code 0. D. Go to the patients side to see if they ... males & females, ages 18 and over. Patients have psychiatric disorders with concurrent criminal involvement or are highly dangerous, requiring inpatient care in a… more
- State of Colorado (Pueblo, CO)
- …delegated by the team within scope. C. Remain with the patient and yell for help/ medical emergency/ code 0. D. Go to the patient's side to see if they ... males & females, ages 18 and over. Patients have psychiatric disorders with concurrent criminal involvement or are highly dangerous, requiring inpatient care in a… more
- State of Colorado (Pueblo, CO)
- …safe, secure, and therapeutic setting for patients with both psychiatric and medical issues. The services provided include evaluation and treatment for patients who ... CMHHIP Adult males, ages 18 and over. Patients have psychiatric disorders with concurrent criminal involvement or are highly dangerous, requiring inpatient care in a… more
- Beth Israel Lahey Health (Boston, MA)
- …care being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure criteria for ... Position Summary: In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status based on… more
- St. Luke's University Health Network (Allentown, PA)
- …+ Conducts reviews of cases lost with feedback to respective departments + Conduct concurrent review with utilization review department for post op surgical ... Surgical Review Specialist prospectively reviews, validates, and audits procedure code assignment in accordance with AHA ICD-10-CM and AMA CPT-4 coding… more
- Hartford HealthCare (Farmington, CT)
- …experience in an acute care hospital setting. . Two years denials review , auditing, management, mentoring and/or coder training experience. *Licensure, ... coding teams as needed. . Participatesin the development and review of HIM Coding Policy and Procedures. . Participates...for the team. ** . Leads and manages multiple concurrent projects, prioritizes tasks and adapts to frequent changes… more
- Swedish Health Services (Seattle, WA)
- **Description** **Utilization Review RN** **Full time 1 FTE** **Day Shift** The Utilization Review (UR) Nurse has a strong clinical background blended with a ... well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by… more
- Medical Mutual of Ohio (OH)
- …, which includes experience communicating with providers.** + ** Medical /clinical background highly desirable.** **Professional Certification(s)** + **Registered ... Founded in 1934, Medical Mutual is the oldest and one of...to ensure appropriate delivery approach and assist in the review of provider agreements.** + **Acts as project manager… more
- Nuvance Health (Danbury, CT)
- …Auditor performs detailed chart to bill audits of inpatient or outpatient medical accounts, comparing the medical record documentation with the itemized ... coordinates and reports audits savings or losses for the facilities and medical groups, data processing errors, the performance of the hospitals and physician… more
- Catholic Health Initiatives (Chattanooga, TN)
- …American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC) required. Professional Medical Auditor Certification (CPMA) ... **Overview** **CHI Memorial Mountain Management** CHI Memorial Medical Group (Mountain Management Services), now part of...for the purpose of accurately reporting HCC's. Prospective and concurrent reviews will account for 70% of the workload… more