Consultative Coding Professional Humana IncConsultative Coding ProfessionalNVRemote$59,300–$80,900 / yearWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
CODING DIAGNOSTICIAN Carson Tahoe Regional HealthcareCODING DIAGNOSTICIANCarson City, NVRemoteAssigns and audits compliant, complete, and accurate APC's, ICD-9-CM diagnosis codes, CPT/HCPCS procedure codes, E/M facility level codes, and modifiers for the hospital outpatient and inpatient services to include Cardiac Catheterization, Lab, and Electrophysiology, along with the technical codes. Seeks out missing information and creates complete records, including items such as disease and procedure codes, point of origin code, discharge disposition, date of surgery, attending physician, consulting physicians, surgeons and anesthesiologists, and appropriate signatures/authorizations.
NewCLINICAL CODING SPECIALIST Carson Tahoe Regional HealthcareCLINICAL CODING SPECIALISTCarson City, NVLevel II (Intermediate - Coder Outpatient Professional, Surgery, ER): Handles more complex outpatient and professional services coding, including APCs, CPT/HCPCS, E/M coding, and modifiers across multiple outpatient settings. Perform coding across a range of care settings depending on level and assignment, including: Outpatient hospital services, Emergency Department, Urgent Care, Observation, and Ambulatory Surgery (intermediate level).
NewNON-CLINICAL CODING AUDITOR AND TRAINER Carson Tahoe Regional HealthcareNON-CLINICAL CODING AUDITOR AND TRAINERCarson City, NVThis position ensures that billing is optimized, and errors are minimized by identifying opportunities through audit and observation; remaining abreast of regulatory and procedure changes which may affect coding compliance and /or reimbursement. Work closely with HIM and Coding leadership to complete new provider audits, including documentation review during first month and audit of charges to ensure coding accuracy.
Coding Lead Renown HealthCoding LeadReno, NVLicense(s): Certification(s): CCS or RHIA/RHIT with a minimum of four years of facility coding experience is required Computer / Typing: Must possess, or be able to obtain within 90 days,the computers skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc. Accurate translation of written diagnostic descriptions to appropriately and accurately assign ICD-9-CM/ ICD-10-CM diagnostic codes and procedural codes to obtain optimal reimbursement from all payer types, including Medicare/Medicaid, and private insurance payers.
Coding Educator Renown HealthCoding EducatorReno, NVExcludes apprenticeship classification) Computer / Typing: Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel, Teams, and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc. Nature and Scope Incumbent is responsible for conducting and coordinating audits of providers professional documentation to ensure that correct services are being billed and provide education and consistent feedback to the providers using identified communication tools.
Associate Coding Specialist-Inpt Renown HealthAssociate Coding Specialist-InptReno, NVNature and Scope: Incumbent provides entry level Clinical Outpatient coding support through the Health Information Management department and works in conjunction with the Health Information Management leadership to complete all applicable coding assignments that can include Laboratory, Radiology, Outpatient and hospital clinical visits, Bariatric visits, and other coding assignments as directed by leadership, with the purpose of developing proficiency with coding Emergency Department, Same Day Surgery, and Observation medical records OR Inpatient medical records For compliance, this position must adhere to CMS Official Guidelines for Coding and Reporting. Job responsibilities include the accurate assignment of ICD-9-CM/ ICD-10-CM diagnostic codes by proficiently translating diagnostic statements, physician orders, and other pertinent documentation; Leading to coding accuracy and abstracting of pertinent data elements from documentation provided to report and code for reimbursement of revenue.
Supervisor of Coding Renown HealthSupervisor of CodingReno, NVIncumbent must be trained in the anatomy and physiology of the human body and disease processes in order to understand the etiology, pathology, symptoms, signs, diagnostic studies, treatment modalities, and prognosis of diseases and procedures to be coded and to provide direction and mentoring of staff to ensure their understanding of coding principles and correct coding initiatives. The incumbent performs ICD-9-CM/ICD-10-CM/PCS and CPT coding, coordinates HIM initiatives to ensure accurate reimbursement in the Revenue Cycle, monitors productivity, and performs retrospective reviews for coding accuracy and educational opportunities.
Medical Review Nurse (RN) Molina Healthcare IncMedical Review Nurse (RN)Reno, NVReevaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of relevant and applicable state and federal regulatory requirements and guidelines, knowledge of Molina policies and procedures, and individual judgment and experience to assess the appropriateness of services provided, length of stay, level of care, and inpatient readmissions. REQUIRED QUALIFICATIONS: At least 2 years clinical nursing experience, including at least 1 year of utilization review, medical claims review, long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience.
Radiologist Tahoe Forest Health SystemRadiologistTruckee, CaliforniaLicensed, Board-certified and credentialed physician, practicing in the specialty of Radiology, interpreting diagnostic imaging tests that involve the use of x-ray, ultrasound, MRI, CT, PET CT, or mammography equipment and performing interventional radiology procedures, all within the scope of practice for Radiology, as defined by the Hospital’s Medical Staff and physician’s clinical privileges approved by the Board of Directors. Responsibilities may include participation in management’s process for selecting and training clinical employees, as requested; delegation of direct and indirect patient care activities to appropriate personnel; addressing complaints and resolving problems.
Family Medicine Physician Tahoe Forest Health SystemFamily Medicine PhysicianTruckee, CaliforniaExamine patients, take medical histories, prescribe medications, counsel patients, order and/or perform diagnostic tests and perform procedures within the scope of practice for Family Medicine, as defined by the Hospital’s Medical Staff and physician’s clinical privileges approved by the Board of Directors. Responsibilities may include participation in management’s process for selecting and training clinical employees, as requested; delegation of direct and indirect patient care activities to appropriate personnel; addressing complaints and resolving problems.
NewCertified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)NV$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.
Coder II Healthcare Outcomes Performance CompanyCoder IIReno, NevadaDemonstrates knowledge of sequencing diagnoses and procedure codes outlined in the ICD-10-CM Official Coding Guidelines, Uniform Hospital Discharge Data Set, CMS guidelines, and other resources as applicable. Utilizes individual hospital medical record systems and coordinates with physicians and staff to obtain clinical documents and demographics required for appropriate coding and billing for all hospital procedures.
CODER OUTPATIENT PROFESSIONAL Carson Tahoe Regional HealthcareCODER OUTPATIENT PROFESSIONALCarson City, NVThe Clinical Coding Specialist Level I assigns compliant, complete, and accurate ICD diagnosis codes for the hospital component of outpatient ancillary services, based upon the clinical documentation provided within the medical record. Clarify with the appropriate provider and HIM analysts all incomplete, ambiguous, and / or conflicting clinical documentation when further specificity is needed for accurate and complete diagnosis(es) code assignment.
Professional Services Coder Renown HealthProfessional Services CoderReno, NVOther responsibilities include: Assigns codes for diagnoses, treatments, and procedures according to the appropriate classification system for professional service encounters to determine the highest level of specificity ICD-10 codes, CPT codes, HCPCS codes, and modifiers. Review documentation (and returned accounts) to verify and correct place of service, billing and service providers, or other missing data elements (ie: NDC, or number of units) Uses CCI edit software to check bundling issues, modifier appropriateness, and LCDs/NCDs for medical necessity.
Charge Master Analyst Sutter HealthCharge Master AnalystCarson City, NV$106,745.60–$160,118.40 / yearPosition Overview: Serves as a subject matter expert for Charge Description Master (CDM) regulatory requirements and guidelines and payer contractual obligations in order to ensure CDM line items are aligned with current billing, coding regulations, guidelines, and contractual obligations. Maintains the CDM data elements (billing description, Current Procedural Terminology/Healthcare Procedure Coding System codes, revenue codes for Inpatient/Outpatient and appropriate modifiers) in the CDM software.
NewMANAGER REVENUE INTEGRITY Carson Tahoe Regional HealthcareMANAGER REVENUE INTEGRITYCarson City, NVThe Manager partners closely with clinical, operational, finance, coding, billing, compliance, and information technology teams to identify revenue opportunities, resolve charge and billing issues, improve workflows, and ensure services are accurately represented throughout the revenue cycle. Oversees Charge Description Master (CDM) governance and maintenance, including annual updates, new services, charge codes, CPT/HCPCS mapping, revenue codes, pricing changes, and other regulatory updates.
Nocturnist - Hospitalist - Full-Time, Part-Time or Per Diem Tahoe Forest Health SystemNocturnist - Hospitalist - Full-Time, Part-Time or Per DiemTruckee, CaliforniaProvide inpatient hospital care, including admission histories and physicals, daily rounds / patient visits, procedures, discharges, and other appropriate care in accordance with approved clinical privileges, Hospital and Medical Staff policies, bylaws and rules and regulations. Along with other members of the Hospitalist team, provide on-call coverage for shifts as assigned, on-site or off-site by telephone, responding within time frames established by the Medical Staff for emergency, urgent and routine requests.
Coordinator of Billing Compliance Renown HealthCoordinator of Billing ComplianceReno, NVNature and Scope: Under the general direction of the Corporate Compliance Officer, the Billing Compliance Coordinator is responsible for identifying and assessing areas of compliance risk; assisting with the development and implementation of compliance training and education programs; serving as a point of contact for Renown Health employees regarding potential compliance concerns and questions; researching federal and state regulations; monitoring and communicating regulatory changes that impact Renown Health entities; and supporting the Corporate Compliance Officer in timely detection, response, investigation, analysis and applicable corrective action pertaining to any compliance matter. Computer / Typing: Must be proficient with Microsoft Office Suite, including Outlook,PowerPoint, Excel and Word andhave the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.
Claim Benefit Specialist CVS Health CorpClaim Benefit SpecialistNV$17–$28.46 / hourAnalyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department. Documents claim information in the company system, assigning appropriate codes, modifiers, and other necessary data elements to ensure accurate tracking, reporting, and processing of claims.