- Fallon Health (Worcester, MA)
- …at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. **Responsibilities** The Chart Review Specialist primary responsibility is to review ... patient charts for the purpose of validating regulatory Risk Adjustment scores. The Chart Review Specialist will collect diagnostic details and documentation… more
- HonorHealth (Scottsdale, AZ)
- …across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of health care ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- Penn Medicine (Philadelphia, PA)
- …CDI system of record to truthfully demonstrate current state discovered via chart review , discovery of qualities needing further provider clarification, ... Physician or designee requesting appropriate documentation. + Ongoing concurrent chart review , identification of complications and co-morbidities, collaboration… more
- Aston Carter (Stockton, CA)
- …charges, payments, adjustments, and any follow-up necessary for Self-Pay, Medi Cal, Medicare , and third-party payers. . Reviews patient chart documentation to ... in your community? We are looking for a Billing Specialist to join the team! The Billing Specialist...billable services based on payer. guidelines that include Medi-Cal, Medicare , Commercial, and State Specialty Programs. . Evaluate the… more
- Hackensack Meridian Health (Neptune, NJ)
- …and serve as a leader of positive change. The Clinical Documentation Specialist facilitates improvement in the overall quality, completeness and accuracy of medical ... admissions and observations as specified by the facility's Utilization Management/ Review Committee for documentation completeness and compliance with patient status.… more
- Fairview Health Services (St. Paul, MN)
- …professional standards. Evaluates patient progress daily via chart review and/or collaboration with care transitions specialist . Obtains necessary ... primary physician on all cases related to level of care and status. Documents review information in chart , as appropriate. Acts as financial steward by… more
- VNS Health (Manhattan, NY)
- …leadership of trends and irregularities evidencing deviations from coding protocols. Conducts chart review around Provider Risk Adjustment Activity and clinical ... CMS Hierarchical Condition Categories (HCC). Participates in and supports the Medicare Risk Adjustment team-based environment to educate providers on coding… more
- HCA Healthcare (Austin, TX)
- …compelling, we encourage you to apply for our Medical Business Office Specialist opening. We promptly review all applications. Highly qualified candidates ... and inclusion thrive? Submit your application for our Medical Business Office Specialist opening with St. David's Austin Area Ambulatory Surgery Center today and… more
- Corewell Health (Stevensville, MI)
- …of last day of Medicare A coverage. + Performs audits and quality review duties as assigned by Manager. Monitors accuracy of MDS items completed by other ... Ridge is a 111-bed Skilled Nursing Facility that is Medicare and Medicaid Certified with 33 private rooms and... and Medicaid requirements. Essential Functions + Reviews nursing chart on resident information and performs evaluations as needed… more
- Sharp HealthCare (Santee, CA)
- …Plan of Care (POC), patient status reports) prior to their due date.Participates in chart review and implements suggestions for improvement, and initiates peer ... possible solution to the PT Supervisor or supporting clinical lead or specialist for resolution in a timely manner.Consults and listens, effectively communicates,… more
- VNS Health (Manhattan, NY)
- …and compliance in the healthcare field? We are seeking a skilled Home Coding Specialist to review and audit claims, ensuring they meet all billing, coding, ... metrics are noted on claim, as provided during the encounter. Performs medical chart reviews to validate codes for quality monitoring, reporting, and analysis. +… more
- Virginia Mason Franciscan Health (Gig Harbor, WA)
- …documentation that meets the accepted clinical, hospital and departmental standards and chart review criteria. + Completes documentation responsibilities in a ... Health, is currently seeking a full time Behavioral Health Specialist for our Franciscan Behavioral Health in Gig Harbor,...according to hospital and departmental criteria. + Participates in chart review process and adjusts practices according… more
- Lancaster General Health (Lancaster, PA)
- **Summary** **Job Description** **POSITION SUMMARY:** The Coding Specialist is responsible for supporting Penn Medicine Lancaster General Health Physicians (LGHP) by ... as a resource to practices for coding issues and education. The Coding Specialist helps to optimize revenue through appropriate coding while adhering to official… more
- AdventHealth (Glendale Heights, IL)
- …with physicians, nursing and HIM coders, the Clinical Documentation Specialist (CDS) strategically facilitates and obtains appropriate and quality physician ... of mortality (ROM) and quality. * Completes accurate and timely record review to ensure the integrity of documentation compliance. Completes accurate and concise… more
- Martin's Point Health Care (Portland, ME)
- …in Primary Care. Job Description Key Outcomes: + Manages and appropriately updates chart by review of consult notes and identifies key changes requiring ... Work" since 2015. Position Summary The Clinical Inbox Nurse Specialist is a hybrid role offering opportunity for flexible...provider review + Identifies and prioritizes urgent patient concerns, escalating… more
- Whitney Young Health Center (Watervliet, NY)
- …medical service provision, patient case management, follow-up, and billing; Local Medical Review Policies (LMRP) for Medicare and Medicaid services; Medical ... Claims Coding Specialist (Req 100825) Watervliet, NY (http://maps.google.com/maps?q=1601+Broadway+Watervliet+NY+USA+12189) Apply Description GENERAL… more
- Ciena Healthcare (Richmond, VA)
- …as needed for MDS nurses in assessing resident through physical assessment, interview and chart review . + Assist MDS nurses in follow up on resident care ... join Ciena Health Care Company as a Clinical Resource Specialist , you will share your expertise with the MDS...facilities. In this role, you will audit and evaluate Medicare compliance and the RAI process in four facilities… more
- AdventHealth (Orlando, FL)
- …with physicians, nursing and HIM coders, the Clinical Documentation Specialist (CDS) strategically facilitates and obtains appropriate and quality physician ... of mortality (ROM) and quality. + Completes accurate and timely record review to ensure the integrity of documentation compliance. Completes accurate and concise… more
- Boys Town (Omaha, NE)
- …completes daily workflow of denials and no response from insurance payers for HCFA/UBO4, chart notes/faxes and appeals worked in a timely manner to ensure claims are ... ABILITIES: + Ability to apply moderate analytic skills to review data and trends, as well as to organize...resources. + General understanding and knowledge of Center for Medicare and Medicaid Systems (CMS) billing and coding requirements… more
- The Cigna Group (Chattanooga, TN)
- …Rely upon independent judgment and decision-making at provider sites, whether conducting chart review or providing training/education, both for historical and/or ... the Risk Adjustment program to ensure correct coding and documentation. + Conduct chart reviews for providers and review provider performance. This is… more