The Appeals and Recovery Support Specialist position investigates, examines and reviews claims' appeals, recoveries, and escalations in accordance with state and federal insurance regulations, government statutes, and NCQA/CMS standards. This position communicates regularly with various levels of the organization to resolve appeals and escalations, serving as a valuable r

Scan and attach all internal and external correspondence and electronic medical reports to the patient's medical record chart according to the filing system. Pulls charts for scheduled appointments in advance according to guidelines. Ensure that all appropriate documentation for the scheduled patient visit is attached to the patient's chart. Prints, mails, and/or faxes pa

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

Aya Healthcare has an immediate opening for the following position Certified Surgical First Assistant in Las Vegas, NV. We'll work with you to build the healthcare career of your dreams. Whether you want a job close to home or across the country, we've got you. Job Details Pay $2088.48/week $2283.46/week Assignment Length 13 week assignment Shift 5, 8 Hour 11 00 19 30 At

Aya Healthcare has an immediate opening for the following position Certified Surgical First Assistant in Las Vegas, NV. We'll work with you to build the healthcare career of your dreams. Whether you want a job close to home or across the country, we've got you. Job Details Pay $2088.48/week $2283.46/week Assignment Length 13 week assignment Shift 5, 8 Hour 11 00 19 30 At

Assigns appropriately sequenced and compliant ICD 10 CM/PCS codes as documented in the electronic medical record (EMR). Applies definition of principal diagnosis for proper assignment of MS DRGs, APR DRGs, and POA indicators using a designated encoder/grouper, while ensuring compliance with nationally established coding guidelines. Utilizes selected encoder and/or compute

Include Ensure patient demographic information is accurate and complete Utilize customer hospital systems or approved vendors to research and obtain/verify patient demographic information Validate signature documents such as AOB (Assignment of Benefits), consents, CMN (Certificate of Medical Necessity) Verify patient name is consistent on all documents Verify date of servi

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 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 accuracy of the overall clinical picture and the representation of the complexity and severity of illness of patients through improved clinical documentation and d

Performs review of the medical record including documentation, reports, flowsheets, and test results, applying evidence based criteria related to DRG and clinical validation denials Creates appeal letters utilizing the relevant information from the medical record; supported by current clinical standards and facility guidelines, evidence based medicine, professionally reco

Western Region CBO The Western Region Consolidated Business Office provides business office services including billing, collections, cash posting, pre access management, variance and customer service to our affiliated UHS facilities. We are seeking dynamic and talented individuals to join our team. Job Description The Patient Accounts Specialist/Collections is responsible

Western Region CBO The Western Region Consolidated Business Office provides business office services including billing, collections, cash posting, pre access management, variance and customer service to our affiliated UHS facilities. We are seeking dynamic and talented individuals to join our team. Job Description Responsible for the maintenance and processing of patient

Interact with customers gathering support data to ensure invoice accuracy and work through specific billing discrepancies Must be able to process through minimum of 50 accounts/claims per day Provide input to policies, systems, methods, and procedures for the effective management and control of the premium billing function Educate customers regarding the availability of r

Western Region CBO The Western Region Consolidated Business Office provides business office services including billing, collections, cash posting, pre access management, variance and customer service to our affiliated UHS facilities. We are seeking dynamic and talented individuals to join our team. Job Description Responsible for the maintenance and processing of patient

Providence caregivers are not simply valued they're invaluable. Join our team and thrive in our culture of patient focused, whole person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence is calling a Senior Coding Quality Educator who will Assis