- Owens & Minor (Tallahassee, FL)
- …**POSITION SUMMARY:** This representative will be required to request Medical documentation and assure received documentation meets insurance payer guidelines. ... including: + Prepayment audits/development letters + Post payment requests for documentation + Overpayment refund requests + Medical necessity documentation … more
- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and ... documentation , working closely with physicians, IPA coders, and risk...A Certified Professional Coder (CPC) certification or Certified Coding Specialist (CCS) certification, required + A Certified Risk Adjustment… more
- TEKsystems (Houston, TX)
- The Billing Support Specialist is designed to streamline patient orders to avoid any unnecessary delays. + Reviewed records for accuracy. + Obtained needed documents ... for missing information on records. + Request necessary documentation (chartnotes, prescription request, medical records, etc) to bill Medicare . + Ensuring… more
- TEKsystems (Des Moines, IA)
- Description The Billing Support Specialist will be responsible for ensuring orders are tasked appropriately between different systems. A Billing Support ... Specialist determines where orders must be tasked to ensure...needed documents for missing information on records. -Request necessary documentation (chartnotes, prescription request, medical records, etc) to bill… more
- PruittHealth (Norcross, GA)
- …**KNOWLEDGE, SKILLS, ABILITIES:** * In-depth knowledge of various billing documentation requirements, the patient accounting system, and various data entry ... codes to ensure proper service documentation and billing of patient accounts. * Knowledge of insurance and governmental programs, regulations and billing processes,… more
- Community Health Systems (Franklin, TN)
- …balances within required time frame. Obtains confirmation of payment or required documentation . + Documents all actions taken on appropriate systems so that is ... clearly communicated process for resolution. + Makes appropriate number of calls based on assigned payer. + Handles and resolves incoming correspondence within 5 days of receipt and updates system + Effectively analyze assigned accounts using AS400, Meditech,… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- The Medicare Billing and Follow-up Representative are responsible for the compliant, accurate and timely billing and follow-up of all hospital Medicare and ... limited as other tasks may be assigned. + Submit Medicare / Medicare Advantage plan claims both electronic and...and using approved abbreviations for universal understanding + Keep documentation clear , concise , and to the point… more
- CaroMont Health (Gastonia, NC)
- …work collaboratively with Health Information Management, Utilization Review and Clinical Documentation Specialist to mitigate coding denials. This position is ... Job Summary: The Clinical Documentation and Denial Specialist will assist...Staff, Physician Advisor, Nursing staff, Commercial Payers, VA, Managed Medicare Organizations, Medicare , and Medicaid (Center for… more
- CVS Health (Hartford, CT)
- …manner. Group Retiree Solutions (GRS) is a core component of the Aetna Medicare Organization. Our vision is to develop an industry-leading group retiree health care ... assessing risks and issues, adhering to timelines as well as executing and ensuring documentation is clear and concise. The ideal candidate will be able to work… more
- Convey Health Solutions (Fort Lauderdale, FL)
- Reporting to the Senior Manager, Professional Services, the Documentation Specialist is responsible for creating, managing, and maintaining accurate and ... years of experience in Medicare Part D and/or Medicare Advantage operations, documentation management, or a related field. * Proven hands-on experience in… more
- AdventHealth (Altamonte Springs, FL)
- …in collaboration with physicians, nursing and HIM coders, the Clinical Documentation Specialist (CDS) strategically facilitates and obtainsappropriate and ... . examination at the time of graduation and . CCDS (Certified Clinical Documentation Specialist ) certification, or/and CDIP (Certified . Documentation … more
- Intermountain Health (Las Vegas, NV)
- **Job Description:** The goal of the Clinical Documentation Specialist -Consultant is to educate leaders, physicians, advanced practice providers (APP), and other ... staff about documentation and risk adjustment in order to improve the...to perform the essential functions. + Knowledge of CMS Medicare , Medicaid, Managed Care and Commercial health plan billing,… more
- MetroHealth (Cleveland, OH)
- …ethnic, racial, and socioeconomic backgrounds. Preferred: Active CCDS (Certified Clinical Documentation Specialist ) from ACDIS (Association of Clinical ... the patient care team both formally and informally regarding clinical documentation guidelines and service specific requirements. Upholds the mission, vision,… more
- Fairview Health Services (St. Paul, MN)
- **Job Overview** Performs concurrent inpatient chart reviews for documentation improvement opportunities. Communicates with physicians to ensure comprehensive ... medical record documentation to reflect clinical treatment and diagnose. Uses provided...according to standards set forth by CMS (Center for Medicare & Medicaid Services) to reflect accuracy with DRG-based… more
- UCLA Health (Los Angeles, CA)
- …required * Knowledge of laws, rules and regulations regarding appropriate clinical documentation for Medicare , Medi-Cal, CCS etc. * Strong leadership, ... Health. You will become a member of our highly successful of our Documentation Improvement Integrity team, including all modalities. This will involve daily reviews… more
- Ventura County (Ventura, CA)
- …for Medi-Cal and/or Medicare and prepares reports; + Serves as lead biller/ specialist to the department; and + Performs other related duties as required. Medical ... Medical Billing Specialist III/IV Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4539404) Apply Medical Billing Specialist III/IV Salary… more
- Randolph Hospital (Asheboro, NC)
- Responsible for clinical documentation improvement of medical records. Works closely with Resource Management, Health Information Management, and physicians to ... assure documentation accurately reflects severity of illness and risk of...Knowledge of ICD-9-CM, CPT-4 coding guidelines. Knowledgeable of current Medicare and Medicaid rules and regulations. Experience in encoder… more
- AnMed Health (Anderson, SC)
- This position is responsible for performing concurrent review of the clinical documentation in the medical record within the Clinical Effectiveness program at AnMed. ... as necessary via written/verbal communication to obtain accurate and complete physician documentation that supports the severity of patient illness and risk of… more
- City of New York (New York, NY)
- …outreach initiatives to educate and empower our community. The Health Benefits Information Specialist plays a key role in assisting Medicare beneficiaries by ... older adults navigate the complexities of all components of Medicare . HIICAP conducts public outreach presentations and workshops to...to join our team as a Health Benefits Information Specialist . In this role, you will be tasked to… more
- USAA (Charlotte, NC)
- …**The Opportunity** USAA Life Company's Claim Team is seeking a talented **Medical Specialist Principal** to play a crucial role in advising the Medicare ... on the morbidity and claims risk of health policies, including Medicare Supplement contracts and claims. The responsibilities will include providing support… more