• Clinical Denials Coding Review

    HCA Healthcare (Nashville, TN)
    …colleagues invested over 156,000 hours volunteering in our communities. As a Clinical Denials Coding Review Specialist with Work from Home you can be a part ... to succeed in our organization. We are looking for an enthusiastic Clinical Denials Coding Review Specialist to help us reach our goals. Unlock your potential!… more
    HCA Healthcare (02/20/25)
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  • Coding Quality Auditor

    Houston Methodist (Nashville, TN)
    …rules and regulatory body guidelines. This position performs data quality review to ensure data integrity, coding accuracy, and revenue preservation. ... ** Coding Quality Auditor - 100% Remote...Additional duties include participating in quality review and performance improvement projects throughout… more
    Houston Methodist (02/07/25)
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  • Medical Coding Quality Auditor

    Humana (Nashville, TN)
    …health first** The Quality Assurance department is looking for Medical Coding Quality Auditor for outpatient setting with Evaluation Management leveling ... Outpatient Coding Team and vendor partners. **Medical Coding Quality Auditor** The Quality ...Do you have a solid background in medical auditing, coding , and medical record review ? If you… more
    Humana (03/22/25)
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  • Inpatient Coding Quality Auditor

    HCA Healthcare (Nashville, TN)
    …Do you want to join an organization that invests in you as an Inpatient Coding Quality Auditor? At Work from Home, you come first. HCA Healthcare has ... you have the opportunity to make a difference. We are looking for a dedicated Inpatient Coding Quality Auditor like you to be a part of our team. **Job Summary… more
    HCA Healthcare (03/23/25)
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  • Outpatient Coding Manager

    HCA Healthcare (Nashville, TN)
    …College Graduate preferred + Certified as a RHIA, RHIT or CPC preferred + Physician coding and/or coding quality monitoring experience helpful + Ability to ... improvement of human life and strives to deliver high quality , cost effective healthcare in the communities we serve....address the needs of the client. + Maintains an education program to continually develop technical coding ,… more
    HCA Healthcare (02/15/25)
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  • Inpatient Coding Manager

    HCA Healthcare (Nashville, TN)
    …identifies ways to address the needs of the client. + Maintains an education program to continually develop technical coding , Health Information Management ... an organization that invests in you as a Inpatient Coding Audit Manager? At HCA Healthcare, you come first....+ Employee Discounts including Tickets, Retail, Mental Health Apps, Education Apps, Identity Theft Protection etc. + Home, Auto,… more
    HCA Healthcare (02/08/25)
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  • Outpatient Coding Team Lead

    HCA Healthcare (Nashville, TN)
    …validation) + Provides timely feedback and education as it relates to coding opportunities found during the review of accounts + Ensures rebill requests ... provide support to coding leadership by coordinating coding and education activities within the HSC....in this role:** + Leads, coordinates and performs HSC coding quality reviews (eg, routine, policy driven,… more
    HCA Healthcare (03/07/25)
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  • DRG Coding Auditor

    Elevance Health (Nashville, TN)
    …performing clinical reviews of medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review of DRG ... Coding / Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. +...stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates… more
    Elevance Health (03/14/25)
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  • Hierarchical Condition Category (HCC)…

    Highmark Health (Nashville, TN)
    …accuracy and productivity requirements. + Assists with Regulatory Audits by performing first coding review and ranking of charts. Build partnerships and work ... , Compliance, partners at Enterprise and leadership to identify and deliver high quality and accurate risk adjustment coding . Supports all Remote Patient… more
    Highmark Health (03/04/25)
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  • Remote Physician Pro Fee Coding

    Community Health Systems (Franklin, TN)
    **Job Summary** The Coder Physician provides quality review and analysis of a wide range of patient medical records and ensures accuracy of coding . This role ... of Physician Coding and Documentation. + Reports coding related issues and/or opportunities to the education team to allow that team to work with the… more
    Community Health Systems (02/04/25)
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  • Outpatient Coder

    Houston Methodist (Nashville, TN)
    … team and the appropriate stakeholders. + Participates and provides good feedback during coding section meetings and coding education in-services as well as ... /SAFETY ESSENTIAL FUNCTIONS** + Maintains and achieves departmental standards of coding quality by assigning accurate ICD-10-CM/ICD-10-PCS and CPT codes… more
    Houston Methodist (03/04/25)
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  • Inpatient Coder

    Houston Methodist (Nashville, TN)
    … team and the appropriate stakeholders. + Participates and provides good feedback during coding section meetings and coding education inservices as well as ... ESSENTIAL FUNCTIONS** + Maintains and achieves the highest standards of coding quality by assigning accurate/ICD-10-CM/ICD-10-PCS codes utilizing an electronic… more
    Houston Methodist (03/04/25)
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  • Vendor Resource Management Assistant Director

    HCA Healthcare (Nashville, TN)
    …with the management team. + Assist with review of quality standards, productivity standards, coding guidelines, policies and procedures periodically, ... Facilitates communication with strategy partners with any concerns for staffing, TAT, and process/ quality issues. + Assists in training and education for VRM… more
    HCA Healthcare (03/18/25)
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  • Remote Coder III-IP Coder

    Community Health Systems (Franklin, TN)
    …Corporate Coding or other available resources and works out difficult codes and/or coding problems. + Attends coding education as scheduled. + Maintains ... **Job Summary** As a member of the HIM Central Services coding team, the Coder IP provides inpatient coding assistance for a set of HIM Central… more
    Community Health Systems (03/21/25)
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  • Quality Reviewer (Aetna SIU)

    CVS Health (Nashville, TN)
    …(AHFI), or a minimum of three years of Medicaid Fraud, Waste, and Abuse review experience. + Billing and Coding certifications such as CPC (AAPC) and/or ... + Analyze and prepare cases for clinical and legal review , ensuring all documentation meets required standards. + Document...or fraud, waste and abuse. + Knowledge of CPT/HCPCS/ICD coding . + Proficiency in Microsoft Word, Excel, Outlook, database… more
    CVS Health (03/19/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Nashville, TN)
    …documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. **How you will make ... an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of medical audit… more
    Elevance Health (03/04/25)
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  • Informatics Analyst

    HCA Healthcare (Nashville, TN)
    …rollover assistance services and preferred banking partnerships + Education assistance (tuition, student loan, certification support, dependent scholarships) ... **Job Summary and Qualifications** The Informatics Analyst will join the HIM, Coding , and Abstraction department. This department partners with internal HIM, … more
    HCA Healthcare (03/22/25)
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  • Data Abstractor I WFH

    HCA Healthcare (Nashville, TN)
    …Office applications 7. Possess basic keyboard skills 8. Knowledge of medical terminology, quality measures and coding logic. EXPERIENCE: 1. 1 year in Trauma ... readiness, rollover assistance services and preferred banking partnerships + Education assistance (tuition, student loan, certification support, dependent scholarships)...Registry/ Injury Coding Experience Required -AIS 2008 or 2015 Injury … more
    HCA Healthcare (03/14/25)
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  • Special Investigation Unit Manager Clinical…

    CVS Health (Nashville, TN)
    …Coders (CPC). The Manager is responsible for overseeing and managing coding reviews for fraud detection, investigation, and prevention efforts to safeguard ... with regulatory requirements. The Manager develops strategies to manage workload, quality of reviews and process improvements. **Responsibilities:** Lead and mentor… more
    CVS Health (12/25/24)
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  • Manager AI Platform Engineering

    HCA Healthcare (Nashville, TN)
    education and/or experience **Additional Requirements/Preferences:** + Current hands-on coding abilities with recent experience in ML/AI systems or Platforms - ... readiness, rollover assistance services and preferred banking partnerships + Education assistance (tuition, student loan, certification support, dependent scholarships)… more
    HCA Healthcare (03/04/25)
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