perspective on workplace flexibility. Position Purpose: Perform clinical/coding medical claim review to ensure compliance... with coding practices through a comprehensive review and analysis of medical claims, medical records, claims history, state...
an inpatient coding certification (CCS or CIC) within 12 months of hire. College level courses in medical terminology, anatomy..., pathophysiology, pharmacology, and medical coding courses. 5+ years of experience in MS-DRG and APR-DRG coding experience through...
in a foundation of improving the health of our communities. About the Role: Job Summary The Coding Quality Reviewer II... to: Neurosurgery, UI, Neurology, Critical Care, hospitalists, surgical and others as defined. The Coding Quality Reviewer II...
of hire. College level courses in medical terminology, anatomy, pathophysiology, pharmacology, and medical coding courses.... With this role, we are seeking an experienced and credentialed coding professional from either the inpatient hospital setting...
and screenings. EDUCATION / EXPERIENCE Required: Three (3) to five (5) years' experience performing medical record coding...Job Description: JOB SUMMARY Support and provide coding and compliance training to clinical personnel, billing...
/coding and managed care processes. Understanding of the medical review (i.e., prior authorization) process and managed care.... Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide...
Summary We are currently hiring for a Medical Reviewer I to join BlueCross BlueShield of South Carolina. In this role... as Medical Reviewer I, you will perform medical reviews using established criteria sets and/or performs utilization management...
Summary We are currently hiring for a Medical Reviewer III to join BlueCross BlueShield of South Carolina.... In this role as Medical Reviewer III, you will perform medical reviews using clinical/medical information provided by physicians...
Overview: Medicare Medical Review RN (Medical Reviewer III) - REMOTE The Medicare Medical Review RN (Medical... Reviewer III) will primarily be responsible for conducting clinical reviews of medical records during the course of fraud...
Job Title: Medical Claims Reviewer Pay: $26-30/hour - Contract to Hire Location: Remote Shift: First (Monday...-Friday 8 AM-5 PM) Position Overview: We are looking for a skilled and detail-focused Medical Claims Reviewer to perform...
Job Title: Medical Claims Reviewer Pay: $26-30/hour - Contract to Hire Location: Remote Shift: First (Monday...-Friday 8 AM-5 PM) Position Overview: We are looking for a skilled and detail-focused Medical Claims Reviewer to perform...
Job Title: Medical Claims Reviewer Pay: $26-30/hour - Contract to Hire Location: Remote Shift: First (Monday...-Friday 8 AM-5 PM) Position Overview: We are looking for a skilled and detail-focused Medical Claims Reviewer to perform...
Special Investigations Unit Medical Reviewer (SIU Medical Reviewer) performs reviews of medical records and healthcare claims... Professional Medical Auditor (CPMA), or Certified Coding Specialist (CCS) required. One of the following licenses preferred...
discrepancies, documentation issues, denial management issues and coding concerns in the medical record to the appropriate.../PCS medical coding experience. Strong knowledge of anatomy and physiology, medical terminology, and disease processes...
% Educates internal/external staff regarding medical reviews, medical terminology, coverage determinations, coding procedures...Duties Performs medical reviews using established criteria sets and/or performs utilization management...
regarding medical reviews, medical terminology, coverage determinations, coding procedures, etc. in accordance with contractor...Duties Performs medical reviews using clinical/medical information provided by physicians/providers and established...
. Educates internal/external staff regarding medical reviews, medical terminology, coverage determinations, coding procedures... as possible and in accordance with current evidence-based care guidelines. As part of our expanding team of medical reviewers, you will evaluate the...
of medical services, identify irregularities such as over or under-utilization of services, potential up-coding, over billing...Job Description: Utilize medical necessity criteria from established medical policies and clinical practice...
Anticipated End Date: Position Title: Nurse Reviewer I-1 Job Description: Location: This is a Virtual role... benefits. Works on reviews that are routine having limited or no previous medical review experience requiring guidance...
Anticipated End Date: Position Title: Nurse Reviewer I Job Description: Location: This is a Virtual role... benefits. Works on reviews that are routine having limited or no previous medical review experience requiring guidance...