- Children's Hospital Boston (Boston, MA)
- 75989BRJob Posting Title:Physician Medical Coder (Shared Service Center)Department:Shared Service CenterAutoReqId:75989BRStatus:Full-TimeStandard Hours per ... Week:40 Job Posting Category:FinanceJob Posting Description:The Physician Medical Coder will be responsible for: + Performs complex ICD-10 and CPT review and… more
- State of Massachusetts (Quincy, MA)
- MassHealth is seeking qualified applicants for the position of Medical Coder . The Medical Coder will be responsible for providing clinical coding ... Services* **Organization:** **Exec Office Of Health and Human Services* **Title:** * Medical Coder * **Location:** *Massachusetts-Quincy - 100 Hancock Street*… more
- Atrius Health (Newton, MA)
- …benefit package. **Job:** **Other Allied Health* **Organization:** **Finance* **Title:** *Certified Medical Coder - Remote* **Location:** *Newton MA - Riverside* ... care for more than 690,000 adult and pediatric patients at 30 medical practice locations in eastern Massachusetts. Atrius Health's 645 physicians and primary… more
- IQVIA (Boston, MA)
- **Experienced Certified Medical Biller/ Coder (Remote)** _Remote Role - Location (Open to Remote US)_ As the only global provider of commercial solutions, IQVIA ... what it takes to deliver nationally and internationally. Our teams help biopharma, medical device and diagnostic companies get their therapies to the people who need… more
- Fresenius Medical Center (Waltham, MA)
- …in the interpretation and explanation of data for internal and external customers. **DENIALS MEDICAL CODER FOCUS** **:** + Must have 2+ years of "Denials" ... **POSITION FEATURES:** **Healthcare Coder Denials Experience a Must Have** **PURPOSE AND...diagnosis, HCPC, CPT, Modifiers and any other claims and/or medical justification identified upon claim denial or charge review… more
- Sharecare, Inc. (Boston, MA)
- …Manager + Radiology Technician + Home Health Aide + Occupational Therapist Aide + Medical Coder + Dental Assistant + Experience in customer service in a ... utilization management (UM) status, including but not limited to medical , dental, and vision plans + Provider search (PCP,...present premier provider options, including but not limited to medical , dental, and vision plans + Support for spending… more
- Tufts Medicine (Burlington, MA)
- …and validations of Medicare, Medicaid, Commercial HCCs and DxCG's through medical record reviews. Reviews provider documentation for ICD-10-CM codes to verify ... documentation as it pertains to coding and risk adjustment guidelines. Reviews medical records to determine if diagnostic codes (ICD-10-CM) as well as Current… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** **Position Summary:** The FWA Investigator Coder Sr. Associate is an integral part of the Fraud, Waste & Abuse (FWA) Special ... departments related to review processes and results. Sr Associate, FWA Investigator Coder utilizes claim analysis, document review, coding knowledge and applies FWA… more
- Highmark Health (Boston, MA)
- …Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** + Demonstrated ability to solve ... and retrospective claims review basis. Review process includes a review of medical documentation, itemized bills, and claims data to assure appropriate level of… more
- Highmark Health (Boston, MA)
- …Health Network **Job Description :** **GENERAL OVERVIEW:** This job performs thorough medical record review to abstract medical and demographic data, interpret ... accounts receivable days. **ESSENTIAL RESPONSIBILITIES** + Reviews and interprets medical information, physician treatment plans, course, and outcome to determine… more
- Children's Hospital Boston (Boston, MA)
- 76464BRJob Posting Title:HIM Clinical Inpatient Coder II - (Remote)Department:Finance-Patient Financial ServicesAutoReqId:76464BRStatus:Full-TimeStandard Hours per ... and Uniform Hospital Discharge Data Set UHDDS definitions to medical records of complex discharged inpatients including cases such...and maintenance of patient database. The HIM Clinical Inpatient Coder II - Remote will be responsible for: +… more
- Beth Israel Lahey Health (Boston, MA)
- …administrative and project support to the department. Analyzes surgical- medical documentation, provides the individual surgeon/physician with the application ... 1. High School diploma or GED required. 2. Certificate 1 Certified Professional Coder required., or Certificate 2 Certified Coding Specialist required. 3. 3-5 years… more
- Intermountain Health (Boston, MA)
- …continuing education programs to maintain an understanding of anatomy, physiology, medical terminology, disease processes, and surgical techniques to support the ... internal audit reviews.12. Identifies the need to clarify documentation in the medical record and communicates with physicians using the appropriate "query" tools… more
- Commonwealth Care Alliance (Boston, MA)
- …employment -- + Certified Professional Coder (CPC) + Certified Inpatient Coder (CIC) + Certified Professional Medical Auditor (CPMA) **Desired Education ... direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective… more
- LogixHealth (Bedford, MA)
- …reviews/revisions + De v el o ps /p r ep ar es Coding Policy for coder production team and client version + Initiates CRM workflow for coding policy additions and or ... and Client Facility Grids + Tracking of audit results / coder booklets + Maintains and updates Coder ...dpro fi c ie ncywith MS Exc el and medical background r eq uired Coding experience and/or certification… more
- CenterWell (Boston, MA)
- …Education, and work as a thought partner with Coding and Documentation Improvement Medical Director. The main responsibilities of the role are: + Determine clinician ... with clinical education team and CDI (coding and documentation improvement) medical director embedded in Clinical excellence. + Align clinician coding education… more
- Highmark Health (Boston, MA)
- …including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and ... ACA HCC Models; works independently in various coding applications and electronic medical record systems to support departmental goals. Adheres to CMS Guidelines for… more
- Conviva (Boston, MA)
- …Qualifications** + A minimum of one year experience as a CPC (Certified Professional Coder ) certification through AHIMA or AAPC + A minimum of two years coding ... training experience + A minimum of two years experience in medical coding collaboration with healthcare providers + Medical record review knowledge + Medicare… more
- Commonwealth Care Alliance (Boston, MA)
- …development of a strategic roadmap to recover, eliminate, and prevent unnecessary medical expense spending and support the execution for a comprehensive claim ... a comprehensive, strategic roadmap to recover, eliminate, and prevent unnecessary medical -expense spending by reviewing upstream and downstream processes. + Identify… more
- Elevance Health (Woburn, MA)
- …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **RN Hospital Audit/Appeal Lead** is responsible for ... + Investigates potential fraud and over-utilization by performing the most complex medical reviews via prepayment claims review and post payment auditing. +… more