NewDenial RN DRG Appeal Writer2 / HIM Coding Hartford HealthCare Corp.Denial RN DRG Appeal Writer2 / HIM CodingPleasant Valley, CTThe level 2 Denial Specialist Appeal Writer reviews and analyzes Diagnostic Related Grouper (DRG) downgrades, preparing detailed, evidence-based appeal letters to defend assigned DRGs and optimize reimbursement. · Provide ongoing education to HHC Institute leaders, providers, coding and CDI teams on DRG validation, documentation best practices, payer guidelines and best practices to minimize future denials.
NewQuality Assurance Performance Improvement Coordinator (RN, Registered Nurse, QA, PI) - HomeCare Hartford HealthCare at HomeQuality Assurance Performance Improvement Coordinator (RN, Registered Nurse, QA, PI) - HomeCareMansfield Center, CTThe QAPI Specialist compiles trends and reports quality data in patient care, safety, risk management, infection control, outcomes and customer satisfaction and performs and uses audit results to lead development of Performance Improvement Plans. The Quality Assurance & Performance Improvement (“QAPI”) Specialist is an individual that will be assisting with agency efforts toward the process of improving clinical documentation and outcomes by taking a systematic, comprehensive, and data-drive approach to maintaining and improving safety and quality.
NewHospice Quality Assurance Performance Improvement Coordinator (RN, Registered Nurse, QA, PI) - HomeCare Hartford HealthCare at HomeHospice Quality Assurance Performance Improvement Coordinator (RN, Registered Nurse, QA, PI) - HomeCareStafford Springs, CTThe QAPI Specialist compiles trends and reports quality data in patient care, safety, risk management, infection control, outcomes and customer satisfaction and performs and uses audit results to lead development of Performance Improvement Plans. The Quality Assurance & Performance Improvement (“QAPI”) Specialist is an individual that will be assisting with agency efforts toward the process of improving clinical documentation and outcomes by taking a systematic, comprehensive, and data-drive approach to maintaining and improving safety and quality.
NewTumor Registrar Middlesex HealthTumor RegistrarNew Britain, CTThe Tumor Registrar (Oncology Data Specialist) assures thorough, accurate and quality data collection as required by the Commission on Cancer (CoC), the Surveillance, Epidemiology and End Results Program (SEER) and State of Connecticut. Serve as a resource for oncology teams by providing data for case reviews, performance improvement initiatives, and clinical research.
NewMedical-Denial Management Specialist Orthopedic Associates of HartfordMedical-Denial Management SpecialistFarmington, CTThe Medical-Denial Management Specialist analyzes and resolves healthcare insurance claim denials by investigating reasons, preparing appeals, communicating with payers, and collaborating with billing staff to ensure proper reimbursement and prevent future denials. Our growing practice is currently seeking a Medical-Denial Management Specialist with Epic experience to join our Billing & Collections team in our Farmington, Connecticut business office.
Clinical Coding Analyst RN, Consultant Blue Cross and Blue Shield AssociationClinical Coding Analyst RN, ConsultantHartford, CTIn this role you will be supporting the FCR team in addition to a small clinical coder team of 2 clinical coders who will be responsible for performing in-depth quality audits of hospital claims to support ICD-10-CM and ICD-10 PCS codes as well as EDC (Emergency Department Coding), MS-DRG and APR-DRG reviews based on clinical determination. Acts as a resource and helps to validate post claim DRG downgrade denials related to coding and clinical determination to support appeal strategy, tracking by disease, payer and denial activity and works with teams to create transparency and improvements to mitigate and prevent denials.
Epic Resolute Application Developer (Charge Router and Coding Skills) - 6260321 Accenture PlcEpic Resolute Application Developer (Charge Router and Coding Skills) - 6260321Hartford, CTIn addition to delivering innovative solutions for Accenture's clients, you will work with a highly skilled, diverse network of people across Accenture businesses who are using the latest emerging technologies to address today's biggest business challenges. Dropping orders using chart review-> creating new patient encounter -> dropping an order and signing the order/Unite charge entry ->creating new encounter.
NewSenior Coding Educator UnitedHealth Group IncSenior Coding EducatorHartford, CT$72,800–$130,000 / yearProvides continuing education supporting medical coders to stay updated with evolving regulations, coding guidelines, and payer requirements, continuing education credits required for professional credentialing maintenance and industry topics for career development. Develop and provide educational programs to assist coders in updated regulatory requirements, coding guidelines, payer requirements, and updated coding topics in large group settings, individual settings, and/or focused groups.
Inpatient Coding / Abstraction Specialist Hybrid Work Environment Hospital for Special CareInpatient Coding / Abstraction Specialist Hybrid Work EnvironmentNew Britain, ConnecticutRequired: Certified Coding Specialist (CCS) or Certified Coding Specialist – Physician-based (CCS-P), or Certified Professional Coder-Payer (CPC-P), or able to achieve certification within 2 years of hire. Educates both medical and clinical staff on appropriate documentation practices, DRG assignment and changes in assignments, modifier usage, changes in software upgrades and communicates guidelines as published by regulatory agencies.
Inpatient Coding Auditor Huron Consulting GroupInpatient Coding AuditorMassachusetts, MARemote$38.46–$52.40 / hourPHYSICAL DEMANDS: This role requires remaining seated at a desk/computer for 8 hours daily; repetitive use of computer keyboard and mouse; use of computer monitors for 8 hours daily; interaction though video/audio conference calls and possible use of a headset with microphone; very rarely duties might require the ability to lift up to 20 pounds and bending & standing for periods at a time. Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes (ICD-PCS), MS-DRG, APR DRG, POA, SOI & ROM assignments.
Outpatient Coder 2 Certified / HIM Coding Hartford HealthCare CorpOutpatient Coder 2 Certified / HIM CodingFarmington, CTAnalyzes medical records, interprets documentation and assigns proper International Classification of Diseases, Tenth Edition Clinical Modification (ICD‑10‑CM), Current Procedural Terminology/HealthCare Common Procedure Coding System (CPT/HCPCS), modifiers, and Evaluation & Management codes utilizing designated software to include Computer Assisted Coding (CAC) and/or encoder, coding manuals and other reference material as required. Reviews accounts returned from various departments (including Customer Service, Billing, Coding Quality, and Revenue Integrity) and processes corrections for clean claim submission or posts claim denial review for appeal.
Outpatient Coder 2 Certified / PB Coding Hartford HealthCare CorpOutpatient Coder 2 Certified / PB CodingFarmington, CTAnalyzes medical records, interprets documentation and assigns proper International Classification of Diseases, Tenth Edition Clinical Modification (ICD‑10‑CM), Current Procedural Terminology/HealthCare Common Procedure Coding System (CPT/HCPCS), modifiers, and Evaluation & Management codes utilizing designated software to include Computer Assisted Coding (CAC) and/or encoder, coding manuals and other reference material as required. Applies strong knowledge of anatomy and physiology, clinical disease processes, pharmacology, and diagnostic and procedural terminology to determine the appropriate assignment of diagnosis and procedure codes.
NewClinic Billing & Scheduling Coordinator Northeast Center for Youth and Families Inc.Clinic Billing & Scheduling CoordinatorEasthampton, MAThe Clinic Billing & Scheduling Coordinator will assist in tracking and obtaining client payments owed, and this position will handle processing all referrals, schedule appointments, and verify current insurance for clients. Northeast Center for Youth & Families, Inc. (NCYF) is made up of a team of devoted and highly skilled professionals and paraprofessionals who provide quality care to the individuals we serve.
Senior Consultant, Health Insurance - Risk Regulatory & Compliance Deloitte Touche Tohmatsu LtdSenior Consultant, Health Insurance - Risk Regulatory & ComplianceHartford, CTThe wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. Our purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities.
NewCertified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)CT$43,888–$102,081 / yearThe Certified Professional Coder (CPC) will perform medical claim reviews to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do.
NewClinic Billing & Scheduling Coordinator Northeast Center for Youth and Families IncClinic Billing & Scheduling CoordinatorEasthampton, MAThe Clinic Billing & Scheduling Coordinator will assist in tracking and obtaining client payments owed, and this position will handle processing all referrals, schedule appointments, and verify current insurance for clients. Northeast Center for Youth & Families, Inc. (NCYF) is made up of a team of devoted and highly skilled professionals and paraprofessionals who provide quality care to the individuals we serve.
NewClinic Billing & Scheduling Coordinator Northeast Center for Youth & Families, Inc. (NCYF)Clinic Billing & Scheduling CoordinatorEasthampton, MAFull timeThe Clinic Billing & Scheduling Coordinator will assist in tracking and obtaining client payments owed, and this position will handle processing all referrals, schedule appointments, and verify current insurance for clients. Northeast Center for Youth & Families, Inc. (NCYF) is made up of a team of devoted and highly skilled professionals and paraprofessionals who provide quality care to the individuals we serve.
NewHIM Audit and Educ Specialist / HIM Clinical Document Mgmt Hartford HealthCare CorpHIM Audit and Educ Specialist / HIM Clinical Document MgmtFarmington, CTCreates and trains on documentation templates designed for specialty/client, e.g., medical reports, monitoring/analysis reports, continuous auditing tools, etc. to insure appropriate documentation is captured for services rendered. Researches literature from regulatory groups such as; HHS/OIG, Medicare, Medicaid, NGS, etc., professional and peer organizations'' practices/policies/guidelines to keep organization current with regulatory requirements and accepted audit and education practices.
Medical Biller All Connecticut Home Care ServicesMedical BillerRocky Hill, CTPart timeYou will also assist other Medical Billers with follow-up inquiries to clients, communicate with physicians' offices and hospitals to obtain records, and accurately record patient information. The ideal candidate has excellent attention to detail, strong customer service skills, and is comfortable spending much of the day on the phone.
Quality Improvement Specialist II Baystate HealthQuality Improvement Specialist IISpringfield, MA$66,081–$75,982 / yearActively pursues effective and efficient operations of their respective areasin accordance withHealth New England’s Values, its Code ofConductand the Associate Handbook, while ensuring the adequacy, adherence to and effectiveness of day-to-day business controls to meet obligations with respect to operational, compliance, and conduct. + Usingmedical record and clinical qualityexpertise, performs HEDIS clinical abstraction in both directelectronic medical record (EMR) and physical medical records to auditprovider compliance with HEDIStechnical specifications.