- Highmark Health (Richmond, VA)
- …Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but ... (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment… more
- Banner Health (VA)
- …record(s) and for quality assurance in the alignment of clinical documentation and billing codes. Works with medical staff and quality management staff to correctly ... align diagnosis documentation and billing coding to improve the quality of clinical documentation...of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG), and Ambulatory Payment Classification… more
- Somatus (Mclean, VA)
- …credentialing packages as required by hospitals, surgery centers, commercial payers, Medicare and Medicaid. Responsibilities + Maintain individual provider files to ... + Complete credentialing applications to add providers to commercial payers, Medicare , and Medicaid. + Complete re-credentialing applications for commercial payers.… more