- CenterWell (Columbia, SC)
- …be the ambassador for value-based, senior care model in the primary care network. The Associate Director , Clinical Coding Education (RN) will develop, ... addition to managing a team of role-based trainers and training facilitators. The Associate Director , Clinical Coding Education (RN) role will report to… more
- CenterWell (Columbia, SC)
- **Become a part of our caring community and help us put health first** The Director , Medical Coding extracts clinical information from a variety of medical ... terminology and medical codes (eg, ICD-10-CM, CPT) to patient records. The Director , Medical Coding requires an in-depth understanding of how organization… more
- Humana (Columbia, SC)
- …these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical … more
- Humana (Columbia, SC)
- …these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- US Tech Solutions (Columbia, SC)
- …+ Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and ... service requests or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/analysis, and comprehensive knowledge of healthcare… more
- US Tech Solutions (Columbia, SC)
- …if the procedure can be approved or denied. Some may need sent to the medical director . They will also need to be flexible to help others in their queue from time ... + Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and… more
- US Tech Solutions (Columbia, SC)
- …of contract language and application. Thorough knowledge/understanding of claims/ coding analysis/requirements/processes. **Education:** + Associate Degree - ... + Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and… more
- CenterWell (Rock Hill, SC)
- …calls from the field staff and assisting with weekly case conferences. Refers clinical questions to Branch Director as necessary. + Maintains the client ... productivity / geographic issues and forwards schedule to Branch Director for approval prior to distribution to staff. +...internal transfer of patients between branch offices. + If clinical , receives lab reports and assesses for normality, fax… more