• Medical Director - Medical Policy & Operations…

    CVS Health (Sacramento, CA)
    …Commercial and Medicare environment. In addition, be a subject matter expert in DRG reviews and ICD-10 code selection. This Medical Director provides subject matter ... improve the quality and efficiency of health care services. ◾Apply clinical coding and reimbursement expertise to ensure alignment and correct application of Aetna… more
    CVS Health (01/19/25)
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  • Facility Coding Manager

    Ellis Medicine (Schenectady, NY)
    …This includes monitoring Discharged Not Final Billed (DNFB) worklists to ensure timely coding /billing. Performs DRG review and works with outsource company for ... work environment and develop the training programs to educate coding . Responsible for continually developing team building...both internal and external + Has the ability to lead meetings that stay on track and move everyone… more
    Ellis Medicine (12/21/24)
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  • Coding Reimbursement Appeals Supervisor…

    Glens Falls Hospital (Glens Falls, NY)
    …Specialists and Providers to educate and offer expertise in the area of documentation, coding and DRG methodologies. Performs ongoing monitoring for coding ... codes that reflect the acuity of our patient and DRG 's that include all MCC's and CC's for reimbursement..../supervisory experience o Associates Degree with-5-7 years of Inpatient Coding and appeal writing experience, highly developed lead more
    Glens Falls Hospital (01/15/25)
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  • Coding Coordinator, Ancillary/Claim Edits…

    Trinity Health (Albany, NY)
    …to coding . Interpersonal skills necessary to effectively interact with the coding team , patients, medical staff, other health ministry departments and any ... focus area and as otherwise necessary to ensure accurate coding and DRG or APC assignment. Develops...and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes… more
    Trinity Health (01/16/25)
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  • Corporate Coding Education Trainer…

    Nuvance Health (Danbury, CT)
    …to ensure alignment with department needs. * Lead training sessions with Team Members to ensure accurate coding assignments. * Ensure compliance through ... Trainer is an important member of the Nuvance Health team . The Education Trainer is responsible for the design,...Coding guidelines, and methodologies. * Expert knowledge of DRG , APC, NCCI, LCD, NCD reimbursement methodologies and expertise… more
    Nuvance Health (12/11/24)
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  • Supervisor, Medical Coding

    University of Rochester (Rochester, NY)
    …to ensure compliance of coding either to an individual or to a team . Prepares orientation materials and orients new hires on coding training, encoder usage, ... Scheduled Weekly Hours: 40 Department: 910503 United Business Office Coding Work Shift: UR - Day (United States of...onboarding of the staff. Assume responsibility of Manager or Lead Coder as appropriate. Works with supervisors of other… more
    University of Rochester (12/17/24)
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  • Remote Inpatient Coder Team Lead

    TEKsystems (Jacksonville, FL)
    …support Levels 1-3 coders and other projects. Details: + Pay: $35 - $40/hr. based on related coding & team lead experience. + Pay cycle - weekly | medical, ... Position Summary: + Leads Inpatient coding team as assigned and backs...+ Various DRG methodologies (MS- DRG , APR- DRG , Tricare, etc.) + IP Rehabilitation IRF-PAI coding more
    TEKsystems (01/11/25)
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  • Clinical Documentation Specialist Lead

    University of Miami (Hialeah, FL)
    …and MS DRG by providing information regarding clinical documentation opportunities, coding , and DRG issues, as well as performance improvement methodologies. ... The Clinical Documentation Specialist 3 serves as a key resource for CDI/ Coding /Quality, and works in collaboration with CDI & quality leadership, CDI specialists,… more
    University of Miami (01/14/25)
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  • Inpatient Coder

    TEKsystems (Atlanta, GA)
    …reviews are done on/96-97% is exceeds, 98% is commendable. 89% on PCS, 91-92% on total coding will lead to a review. Training: - The individual will be set up ... an EPIC assessment. Afterwards, they will work with the DRG Auditor and Coding Manager via Zoom...of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients,… more
    TEKsystems (01/14/25)
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  • Clinical Documentation Improvement Specialist

    Nuvance Health (Poughkeepsie, NY)
    …communications with physicians, interdisciplinary care team members, Department Head, Lead Clinical Documentation Specialist, coding management and coding ... through extensive interaction with physicians, nursing staff, other patient caregivers, The Coding team and Health Information Management Department to ensure… more
    Nuvance Health (12/11/24)
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  • Clinical Documentation Spec 1 / HIM Clinical…

    Hartford HealthCare (Farmington, CT)
    …1 is responsible for extensive record review, and interaction with physicians, HIM coding professionals, nursing staff and other patient care givers to ensure the ... The CDS is also responsible for active participation in team meetings and development of clinical documentation guidelines and...an ongoing basis. CDS 1 may mentor, train or lead other CDS during their orientation period and assist… more
    Hartford HealthCare (12/18/24)
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  • Senior Coder

    Northwell Health (Lake Success, NY)
    …simultaneously to maintain relevant efficiency and turnaround time standards for completing coding / DRG assignment. 9.Assigns and reports all other data elements ... Work Schedule: Sun-Thurs or Tues-Sat/Flexible hours from 7am-7pm Job Description Performs coding and abstracting duties to assure accurate completion of coding more
    Northwell Health (01/18/25)
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  • Director, Clinical Documentation Integrity

    Trinity Health (Livonia, MI)
    …initiatives. Cultivates a positive, professional interdepartmental relationship with HIM directors, coding team , case management, quality, and medical staff to ... Chief Financial Officers, Chief Clinical/Medical Officers, Physician Champions, Quality and Coding leaders to create and implement standards of documentation that… more
    Trinity Health (01/18/25)
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  • Physician Advisor

    Mohawk Valley Health System (Utica, NY)
    …effective and efficient utilization of resources. The Physician Advisor guides the team to improve clinical and financial outcomes with documentation and clinical ... the assigned/estimated GMLOS + Partner with the care management team with the management of LOS, complex care needs...medical staff to facilitate accurate and complete documentation for coding and abstracting of clinical data for: capture of… more
    Mohawk Valley Health System (12/18/24)
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  • Clinical Documentation Specialist-Remote

    Trinity Health (Columbus, OH)
    team , including physicians, patient care services, case management, coding specialists and other healthcare disciplines regarding clinical documentation issues.** ... Management, managed care, or Clinical Documentation and experience in** **ICD-10 coding conventions and DRG methodology preferred.** **Effective Communication… more
    Trinity Health (12/12/24)
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  • Fraud Waste and Abuse (FWA) Audit Manager

    Fallon Health (Worcester, MA)
    …and overall results by line of business for multiple external requirements.Serve as a lead for the team with responsibility for the day-to-day activity to ... in a written report Abstracts CPT, HCPCS, ICD-9/ICD-10, Revenue Codes, and DRG from medical records. Responsible for maintaining current knowledge of coding more
    Fallon Health (11/09/24)
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  • Assistant Director, Corporate Compliance

    Brockton Hospital (Brockton, MA)
    …requirements and identified issues. + Supports internal and external audits of HCPCS, CPT coding , DRG coding , and medical record reviews, using proven ... practicing in 18 ambulatory locations. We believe our distinctive Signature Healthcare team approach is the way healthcare should be: medical professionals across… more
    Brockton Hospital (01/18/25)
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  • RN Care Manager, Post-Acute Clinical Liaison

    Sutter Health (Sacramento, CA)
    …levels of care and associated regulatory compliance requirements. General understanding of coding and DRG assignment process preferred. Must be able to ... fashion. He/She collaborates with patients, families, physicians, the interdisciplinary team , nursing management, quality, ancillary services, third party payers and… more
    Sutter Health (01/17/25)
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  • Sr Analyst, Medical Economics (NY Medicaid Market)…

    Molina Healthcare (Columbus, OH)
    …Economics provides support and consultation to the Health Plan and Finance team through analyzing key business issues related to cost, utilization and revenue ... Python, R, etc.) to answer a given problem + Lead monthly trend presentations to plan leadership and other...systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding /billing (UB04/1500 form) + Demonstrated understanding of key managed… more
    Molina Healthcare (01/21/25)
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  • Provider Contract/CofC Analyst Sr.

    Elevance Health (Wilmington, DE)
    …Health Insurance / Payor reimbursement knowledge preferred * Diagnosis Related Group ( DRG ), Revenue Code, Healthcare Common Procedure Coding System (HCPCS), and ... provider premises during contract negotiations. * Participates on project team involved with enterprise-wide initiatives. **Minimum Requirements** Requires BS/BA… more
    Elevance Health (01/11/25)
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