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.
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.
NewQuality Assurance Performance Improvement Coordinator (RN, Registered Nurse, QA, PI) - HomeCare Hartford HealthCare at HomeQuality Assurance Performance Improvement Coordinator (RN, Registered Nurse, QA, PI) - HomeCareEllington, 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 RegistrarWaterbury, 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.
NewMedical Administrative Assistant Orthopedic Associates of HartfordMedical Administrative AssistantHartford, CTFast paced and challenging, you will interact with our physicians, patients, and other departments to provide the highest level of care for our patients. In support of high-quality patient care, we are currently seeking an experienced Medical Administrative Assistant (MAA) to support our Physicians.
Medical Coding Analyst - Diagnostic Radiology Yale New Haven HealthMedical Coding Analyst - Diagnostic RadiologyNEW HAVEN, ConnecticutRequires occasional ability to lift, push and pull objects such as files and office supplies up to 30 pounds and/or continuously up to 10 pounds; and occasional moving about on foot to accomplish tasks, walking long distances or moving from one work site to another. Reviews and handles interventional procedures performed within Diagnostic Radiology, IE: Breast Imaging procedures, Spine Injections, aspirations etc. to ensure all codes have been appropriately assigned for optimum reimbursement under the direction of the Lead.
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.
Medical Coding And Billing Assistant 1 Yale UniversityMedical Coding And Billing Assistant 1New Haven, CTPerforms 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.
Revenue Coding Analyst Yale New Haven HealthRevenue Coding AnalystNEW HAVEN, CTRequires occasional ability to lift, push and pull objects such as files and office supplies up to 30 pounds and/or continuously up to 10 pounds; and occasional moving about on foot to accomplish tasks, walking long distances or moving from one work site to another. Reviews and handles interventional procedures performed within Diagnostic Radiology, IE: Breast Imaging procedures, Spine Injections, aspirations etc. to ensure all codes have been appropriately assigned for optimum reimbursement under the direction of the Lead.
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.
Manager Clinical Performance & Quality Coding (Nurse Practitioner or PA) Elevance Health IncManager Clinical Performance & Quality Coding (Nurse Practitioner or PA)Wallingford, CTDevelop and manage clinical quality reviews to ensure peer review and clinical quality chart audit process including targeting chart reviews, auditing percentages, score guidelines feedback mechanism and ensure compliance with remediation procedures. Requires a master's in Nursing (or PA equivalent) and at least 3 years of clinical experience in applying appropriate diagnosis in the Medicare HCC Mode; or any combination of education and experience, which would provide an equivalent background.
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.
Manager Clinical Performance & Quality Coding (Nurse Practitioner Or PA) Elevance HealthManager Clinical Performance & Quality Coding (Nurse Practitioner Or PA)Wallingford, CTDevelop and manage clinical quality reviews to ensure peer review and clinical quality chart audit process including targeting chart reviews, auditing percentages, score guidelines feedback mechanism and ensure compliance with remediation procedures. Requires a master's in Nursing (or PA equivalent) and at least 3 years of clinical experience in applying appropriate diagnosis in the Medicare HCC Mode; or any combination of education and experience, which would provide an equivalent background.
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.
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.
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.