• Provider - Based Coding

    Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
    Provider - Based Business Office Manager Job Summary The Provider - Based Business Office Manager will be responsible for managing the Provider - Based ... and implement methods to maximize efficiency and compliance related to coding , billing , accounts receivable, and reimbursement processes and procedures.… more
    Jennie Stuart Medical Center, Inc. (12/20/24)
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  • DRG Coding Team Lead - Full Time

    Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
    …encounters. * Extensive knowledge of hospital and professional coding including provider based billing . * Knowledge of documentation regulations of ... hospital and outpatient services for Inpatient and Outpatient records based on knowledge of coding systems, including...and Outpatient records based on knowledge of coding systems, including ICD-10 and CPT. Daily Functions: .… more
    Jennie Stuart Medical Center, Inc. (12/31/24)
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  • Clinical Content Analyst

    Elevance Health (Louisville, KY)
    …to verify the functionality of the edits. + Applies revenue cycle, coding , and billing expertise to interpret policy based on correct coding , billing ... and interpret CMS, CPT/AMA and other major payer policies based on healthcare correct coding and regulatory...CCI, OIG Alerts, LCAs/LCDs, NCDs, Medicare manuals, etc.) for coding and billing guidelines that can be… more
    Elevance Health (12/21/24)
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  • Program & Curriculum Manager, Medical…

    Cengage Group (Louisville, KY)
    …please see https://www.cengagegroup.com/about/inclusion-and-diversity/ . The **Program & Curriculum Manager, Medical Billing and Coding ** will help to craft the ... will help the team deliver innovative, high-quality products and provide timely support to internal and external partners. **What...certificate upon request) + 3 years experience in Medical Billing & Coding role + 1 year… more
    Cengage Group (12/20/24)
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  • Hierarchical Condition Category (HCC)…

    Highmark Health (Frankfort, KY)
    …Supports other key objectives to drive capture of correct Risk Adjustment coding including documentation improvement, provider education, analyzing reports, and ... None **Substitutions** + None **Preferred** + Associate degree in medical billing / coding , health insurance, healthcare or related field preferred. **EXPERIENCE**… more
    Highmark Health (12/20/24)
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  • Analyst, Coding

    Molina Healthcare (KY)
    …and timely written reports for internal and/external use detailing audit findings. + Renders provider coding education as appropriate based on coding ... potential health care fraud, waste, and abuse through the identification of aberrant coding and/or billing patterns. + Performs medical record audits in order… more
    Molina Healthcare (12/12/24)
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  • Business Office Medical Coding

    Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
    … and medical records of providers + Assigns ICD-10, CPT, and HCPCS codes based on provider documentation. + Reviews, works, and corrects both internal errors ... Responsible for correctly coding healthcare claims in order to obtain reimbursement...patient clinical documents into medical chart. + Ensures all provider services are accounted for and billed. Environmental Services:… more
    Jennie Stuart Medical Center, Inc. (12/19/24)
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  • Investigator, SIU RN-Must reside in Kentucky

    Molina Healthcare (KY)
    …audit findings. * Render provider education on appropriate practices (eg, coding ) as appropriate based on national or local guidelines, contractual, and/or ... knowledge. + Five years experience conducting medical review and coding / billing audits involving professional and facility based services. + Knowledge… more
    Molina Healthcare (12/04/24)
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  • Investigator, SIU

    Molina Healthcare (KY)
    …contract requirements. + Renders provider education on appropriate practices (eg, coding ) as appropriate based on national or local guidelines, contractual, ... include performing accurate and reliable medical review audits that may also include coding and billing reviews. The SIU Investigator is responsible for… more
    Molina Healthcare (12/04/24)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Louisville, KY)
    …guidelines, medical claims billing and payment systems, provider billing guidelines, payer reimbursement policies, and coding terminology preferred. For ... Identifies potential documentation and coding errors by recognizing aberrant coding and documentation patterns such as inappropriate billing for… more
    Elevance Health (01/01/25)
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  • Clinical Documentation Specialist

    Intermountain Health (Frankfort, KY)
    …+ Facilitates and enhances the coding and diagnosis-related group between physician and coding staff. **Skills** + Medical Billing and Coding + Health ... of illness of patients through improved clinical documentation and diagnostic coding practices. **Essential Functions** + Assesses needs and develops, evaluates, and… more
    Intermountain Health (01/01/25)
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  • Sr Analyst, Medical Economics (NY Medicaid Market)…

    Molina Healthcare (Owensboro, KY)
    …subject matter expert on developing financial models to evaluate the impact of provider reimbursement changes + Provide data driven analytics to Finance, Claims, ... standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding / billing (UB04/1500 form) + Demonstrated understanding of key managed care… more
    Molina Healthcare (12/29/24)
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  • Insurance Follow-Up Specialist

    Robert Half Accountemps (Danville, KY)
    …claims, providing necessary documentation and information as required. + Work closely with billing and coding staff to ensure accurate and compliant claims ... The ideal candidate will have a background in medical billing and insurance claims processing, with the ability to...Monitor accounts receivable aging reports and prioritize collection efforts based on account status and aging. + Collaborate with… more
    Robert Half Accountemps (01/03/25)
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  • Specialist, Config Oversight

    Molina Healthcare (KY)
    …and state specific policies and regulations in order to identify incorrect coding , abuse and fraudulent billing practices, waste, overpayments, and processing ... requirements of customers as it pertains to contracting (benefit and provider ), network management, credentialing, prior authorizations, fee schedules, and other… more
    Molina Healthcare (12/05/24)
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  • Senior Medical Underwriter

    Highmark Health (Frankfort, KY)
    …relevant knowledge, skills or experience in relevant field + Professional health claim coding / billing certification + 3 years of clinical practice + Bachelor's ... And if applicable, completes referral requests for case/care management or provider review. The incumbent must communicate effectively with various internal… more
    Highmark Health (12/04/24)
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  • Sr. Coord, Individualized Care (Reimbursement…

    Cardinal Health (Frankfort, KY)
    …insurance benefit practices, preferred * 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience * 1-2 years' experience with Prior ... may receive general guidance on new assignments * May provide general guidance or technical assistance to less experienced...program * Make all outbound calls to patient and/or provider to discuss any missing information and/or benefit related… more
    Cardinal Health (12/11/24)
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  • Quality Reviewer (Aetna SIU)

    CVS Health (Frankfort, KY)
    …a minimum of three years of Medicaid Fraud, Waste, and Abuse review experience. + Billing and Coding certifications such as CPC (AAPC) and/or CCS (AHIMA). + ... lost due to fraud by providing insights and recommendations based on case reviews. + Collaborate with the team...high level of knowledge and expertise during interactions and provide confident testimony during civil and criminal proceedings. +… more
    CVS Health (12/31/24)
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  • Sr. Product Manager

    Waystar (Louisville, KY)
    …to market + An understanding of hospital & professional coding and billing workflows and the provider reimbursement process, obtained either through direct ... complete revenue cycle. Waystar's healthcare payments platform combines innovative, cloud- based technology, robust data, and unparalleled client support to… more
    Waystar (12/17/24)
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  • Manager, Strategic Solutions

    Waystar (Louisville, KY)
    …THIS POSITION** Waystar modernizes the healthcare revenue cycle through innovative, cloud- based technology. We provide the highest-rated client experience to ... Waystar leads the RCM industry provides best in class cloud- based RCM solutions that allow clients to collect more...+ Experience working in healthcare, whether it be medical billing , coding , administration, etc. is preferred +… more
    Waystar (10/29/24)
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  • International Compensation Analyst II - US Remote

    Anywhere Real Estate (Louisville, KY)
    …information in various databases, client specific trackers, and reports + Provide support on shadow payroll reporting by generating compensation reports, timely ... protocol and client-specific policies/processes + Interpret client policies and apply benefits based on the policies + Maintain and enhance relations with Cartus'… more
    Anywhere Real Estate (01/03/25)
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