Denial RN DRG Appeal Writer2 / HIM Coding Hartford HealthCare Corp.Denial RN DRG Appeal Writer2 / HIM CodingAvon, 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.
Quality Assurance Performance Improvement Coordinator (RN, Registered Nurse, QA, PI) - HomeCare Hartford HealthCare at HomeQuality Assurance Performance Improvement Coordinator (RN, Registered Nurse, QA, PI) - HomeCareCoventry, 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.
Hospice 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) - HomeCareManchester, 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.
Tumor Registrar Middlesex HealthTumor RegistrarHartford, 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.
Medical Coding and Billing Assistant 1 Yale UniversityMedical Coding and Billing Assistant 1Connecticut1. Performs work queue resolution of medical billing charge sessions by reviewing clinical documentation to confirm diagnostic (ICD-10) and procedural (CPT/HCPCS) codes and modifiers, based on charge review edits for Yale Medicine patient clinical services filed to charge review work queues. Required Education and Experience Four years of related work experience, two of them in the same job family at the next lower level, and high school level education; or two years of related work experience and an Associate’s degree, or an equivalent combination of experience and education.
NewCoding Auditor - Ambulatory/Professional Coding/Profee Huron Consulting GroupCoding Auditor - Ambulatory/Professional Coding/ProfeeMassachusetts, MA$26.44–$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. Demonstrates knowledge of current, compliant coder query practices when consulting with physicians, Clinical Documentation Specialists (CDS) or other healthcare providers when additional information is needed for coding and/or to clarify conflicting or ambiguous documentation.
Manager Clinical Performance & Quality Coding (Nurse Practitioner or PA) Elevance HealthManager Clinical Performance & Quality Coding (Nurse Practitioner or PA)Wallingford, ConnecticutWe are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. Develop and manage clinical quality reviews to ensure peer review and clinical quali Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health.
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.
Director, Client Coding Integrations Ensemble Health PartnersDirector, Client Coding IntegrationsConnecticutThisroleservesasakeypartnerbetweenCodingOperations,RevenueCycle,ClientServices,Technology,Implementation,andoperationalleadershipteamstoensureseamlesscodingtransitions,operationalreadiness,compliance,andlong-termsuccess. Theidealcandidatewillbringdeepexpertisein professionalfee(physician)coding ,revenuecycleoperations,codingcompliance,providereducation,andclientrelationshipmanagement.
Senior 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.
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.
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.
Student Employment: Game Design Coding Assistant - Fall 26 Quinnipiac UniversityStudent Employment: Game Design Coding Assistant - Fall 26Hamden, ConnecticutJob Title: Game Design Coding Assistant Fall 26 Department: College of Arts & Sciences Student Employment Type: Federal Work Study Responsibilities: Assist students in-class with the CMS/web interfaces in GDD 140. The ideal candidate will have successfully completed GDD 140: Creativity and Computation.
Engineer III - CICD Code Signing Automation (Remote) CrowdStrike IncEngineer III - CICD Code Signing Automation (Remote)CTRemote$120,000–$180,000 / yearAbout the Role: On the Engineering Systems team at CrowdStrike, we operate and maintain many of the systems and services that support the build, test, signing, and deployment of our software to the cloud and to our customers, as well as providing consultation, troubleshooting, and engineering support for the creation and maintenance of the pipelines that provide those functions. We base all employment decisions--including recruitment, selection, training, compensation, benefits, discipline, promotions, transfers, lay-offs, return from lay-off, terminations and social/recreational programs--on valid job requirements.
NewMedical Billing Specialist Mi Familia & Summit Home Health and HospiceMedical Billing SpecialistHartford, CTRemote$58,000–$74,000 / yearThe Medical Billing Specialist will be responsible for processing medical claims, managing insurance reimbursements, resolving billing issues, and ensuring accurate and timely revenue cycle operations. Summit Home Health & Hospice is a Texas-based healthcare organization dedicated to enhancing the lives of patients and families through compassionate home health and hospice services.
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.
Certified 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.