Relying on clinical background, reviews health claims providing medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with Concentra Physician Review policies, procedures, and performance standards and URAAC guidelines and state regulations. Responsibilities MAJOR DUTIES AND RESPONSIBILITIES Rev

As a valued member of the DRG Review Team, the DRG Integrity Specialist performs a secondary level review of medical records and code assignment using knowledge of Accuity technology and client systems with a physician in accordance with federal coding regulations and guidelines as well as client specific coding guidelines to ensure accurate DRG assignment. This function

Health Information Specialist I Job Locations US TN Nashville Requisition ID 2024 35854 # of Openings 1 Category (Portal Searching) Operations Position Type (Portal Searching) Employee Full Time Overview Who we are... Datavant protects, connects, and delivers the world's health data to power better decisions and advance human health. We are a data logistics company for he

Position Description Every day, in ways both big and small, the Medical College of Wisconsin (MCW) is impacting lives for the better. MCW ... change making for a healthier Wisconsin. As a Quality Coding Analyst I, you will serve as an expert resource for multi specialty documentation, coding and billing. Works as an extension to the Charge Capture Supervisory Team to moni

It's More Than a Career, It's a Mission. Our people are the foundation of our success. By joining our growing team at Sarah Cannon Research Institute (SCRI), a subsidiary of McKesson, you will have the opportunity to become part of one of the largest community based cancer programs to advance oncology treatments and improve outcomes for cancer patients across the globe. W

Managing the Centers for Disease Control and Prevention (CDC) grant and that supports the NAS and perinatal substance use program. Establishing and convening an advisory committee consisting of representation from state agencies and external partners. Participate in meetings with CDC and other CDC funded programs. Collaborate with project partners and establish new partne

Identify appropriate assignment of CPT and ICD 10 Codes for outpatient Ambulatory Same Day Surgery services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity Edits Understand the Medicare Ambulatory Payment Classification (APC) codes A

Support request and incidents for facilities in the current support module/system(s), as well as focuses on the technology support for all Lifepoint Health facilities. Provides pharmacy and clinical support in relation to the medication life cycle. Assist in the deployment of all and any technology for upgrades to various technologies. The position assists in the design a

As a valued member of the DRG Review Team, the DRG Integrity Specialist performs a secondary level review of medical records and code assignment using knowledge of Accuity technology and client systems with a physician in accordance with federal coding regulations and guidelines as well as client specific coding guidelines to ensure accurate DRG assignment. This function

The Director, Coding Audits and Appeals is responsible for providing strategic and daily operational management of a team of Coding Denials Auditors. This individual will establish and maintain standards of professional competence, monitoring, and ensuring productivity and quality benchmarks are within acceptable guidelines. The Director, Coding Audits and Appeals combine

Kidlink Treatment Services (a UHS company) Kidlink Treatment Services' network of programs includes more than 50 specialized educational and residential behavioral treatment centers. Each center provides programming for children and adolescents who may have been unsuccessful in previous treatment settings. These services provide access to programs for male and female yout

Design, optimize, test, implement, and monitor scalable data pipelines and data warehousing solutions, including technical oversight and testing of contractors' work. Comprehensively documents data pipelines, processes, and procedures. Facilitates knowledge sharing within the team and across the organization. Enhance and modernize existing legacy algorithms to improve eff

Review pre bill cases simultaneously with a physician during each work shift excluding breaks and meetings to analyze and validate diagnosis and procedure codes for inpatient services via coding compliance and clinical knowledge to support accurate DRG assignment Utilizes Accuity technology for tracking of coding errors, query opportunities and other data collection as ne

Assess the clinical indicators and suggestions of various query requests received from the MD Reviewer/ DRG Integrity Specialist Collaborate and communicate as necessary to clarify and avoid misinterpretation to ensure the query is optimally written and distributed to the correct client provider Creates queries in a compliant manner in accordance with AHIMA and ACDIS comp

Overview Founded in 1971, Dialysis Clinic, Inc. (DCI) remains the nation's largest non profit dialysis provider. With a team of approximately 5,000 talented and caring employees serving across the United States, DCI provides care to nearly 15,000 patients on dialysis and 3,500 patients with chronic kidney disease. We offer a variety of services including in center hemodia