Clinical Coder II Arkansas Children's Hospital NorthwestClinical Coder IILittle Rock, ArkansasCURRENT EMPLOYEES: Please apply via the internal career site by logging into your Workday Account ( https://www.myworkday.com/archildrens/ )and search the "Find Jobs" report. The primary goal is to ensure timely and accurate coding for billing, reimbursement, research, and statistical reporting purposes, while maintaining compliance with established coding guidelines and regulations.
Clinical Coder II Arkansas Children's HospitalClinical Coder IILittle Rock, AR$20.50–$25.60 / hourRequired Work Experience: Recommended Work Experience: Required Certifications: 1 certification from AAPC or AHIMA - American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA). CURRENT EMPLOYEES: Please apply via the internal career site by logging into your Workday Account ( https://www.myworkday.com/archildrens/)and search the "Find Jobs" report.
NewCertified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)AR$43,888–$93,574 / yearThe Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. Uses department resources regularly and follows workflows with minimal assistance or intervention to perform daily work to meet metrics.
Medical Billing Specialist Arkansas DermatologyMedical Billing SpecialistNorth Little Rock, ArkansasWith a wide range of medical and cosmetic dermatology procedures delivered by a team of skilled and experienced professionals, our patients can be confident they are receiving the best care available. The ideal candidate will have a strong background in medical insurance billing, excellent attention to detail, and the ability to work both independently and collaboratively.
NewCoding Data Quality Auditor CVS Health CorpCoding Data Quality AuditorAR$18.50–$38.82 / hourResponsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures. Proficient in abstraction and assignment of accurate medical codes for diagnoses as documented by physicians and other qualified healthcare providers in the office and/or facility setting.
Professional Coding Specialist Arkansas Children's HospitalProfessional Coding SpecialistLittle Rock, ARCURRENT EMPLOYEES: Please apply via the internal career site by logging into your Workday Account ( https://www.myworkday.com/archildrens/)and search the "Find Jobs" report. Required Work Experience: Recommended Work Experience: Required Certifications: Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC).
Professional Coding Specialist Arkansas Children's Hospital NorthwestProfessional Coding SpecialistLittle Rock, ArkansasCURRENT EMPLOYEES: Please apply via the internal career site by logging into your Workday Account ( https://www.myworkday.com/archildrens/ )and search the "Find Jobs" report. 1. Generates, reviews, and interprets reports and dashboards related to coding activities, including volume, turnaround time, denials, and subdivision trends, to identify areas for improvement.
Program Integrity Clinical Specialist (RN or PA Req'd) TriWest Healthcare AllianceProgram Integrity Clinical Specialist (RN or PA Req'd)Little Rock, ARRemoteFull timeTechnical Skills: Knowledge of TRICARE policies and procedures, knowledge of Case Management, Utilization Management, and Quality Management practices and principles, and knowledge of Managed Care concepts, alternative care treatments, and community resources. • Research and investigate medical issues as they relate to potential fraud and abuse cases, to include perform anti-fraud and abuse pre-payment reviews or post-payment reviews.
NewInpatient Audit Specialist FT- Sign on Bonus DatavantInpatient Audit Specialist FT- Sign on BonusLittle Rock, ARRemote$35–$45 / hourAs an Inpatient Auditing Specialist you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, andlife sciences companies.
NewProFee Audit Specialist- FT DatavantProFee Audit Specialist- FTLittle Rock, ARRemote$35–$45 / hourAs a Profee Auditing Specialist, you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, andlife sciences companies.
Audit and Billing Compliance Specialist University of ArkansasAudit and Billing Compliance SpecialistLittle Rock, ArkansasPerforms specific audits outside the audit plan schedule as needed (to include, but not limited to, Office of Inspector General (OIG) audits, Medicare Administrative Contractor (MAC) audits, Recovery Audit Contractor (RAC) audits, Medicaid Integrity Contractor (MIC) audits, etc.). The Audit & Billing Compliance Specialist works under the general direction of the Clinical Billing Compliance Director and reviews medical records and billing system programs to determine coding and billing accuracy and to ensure that all federal and state guidelines for coding and billing are followed.
Case Manager - Care Coordination - Full Time 8 hours Days (Union, Non-Exempt) *Up to $5000 Sign On Bonus* University of Southern CaliforniaCase Manager - Care Coordination - Full Time 8 hours Days (Union, Non-Exempt) *Up to $5000 Sign On Bonus*AR$46–$76.07 / hourSpecific functions within this role include facilitation of pre-certification and payer authorization processes, facilitation of the collaborative management of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement, application of process improvement methodologies in evaluating outcomes of care support and coaching of clinical documentation efforts and serving as a clinical resource for coders, ensuring that documentation accurately reflects severity of illness and intensity of service coordinating communication with physicians. When extending an offer of employment, the University of Southern California Arcadia Hospital considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, key skills, internal peer equity, federal, State, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.
Case Manager - Care Coordinator - Full Time 8 hours Days (Union, Non-Exempt) University of Southern CaliforniaCase Manager - Care Coordinator - Full Time 8 hours Days (Union, Non-Exempt)AR$46–$76.07 / hourSpecific functions within this role include: facilitation of pre-certification and payer authorization processes, facilitation of the collaborative management of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement, application of process improvement methodologies in evaluating outcomes of care support and coaching of clinical documentation efforts and serving as a clinical resource for coders, ensuring that documentation accurately reflects severity of illness and intensity of service coordinating communication with physicians. When extending an offer of employment, the University of Southern California Arcadia Hospital considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, key skills, internal peer equity, federal, State, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.
Case Manager - Care Coordinator - Full Time 8 hours Days (7:30AM - 4:00PM) (Union, Non-Exempt) University of Southern CaliforniaCase Manager - Care Coordinator - Full Time 8 hours Days (7:30AM - 4:00PM) (Union, Non-Exempt)AR$46–$76.07 / hourSpecific functions within this role include: • Facilitation of pre-certification and payer authorization processes • Facilitation of the collaborative management of patient care across the continuum • Intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement • Application of process improvement methodologies in evaluating outcomes of care • Support and coaching of clinical documentation efforts • Serving as a clinical resource for coders • Ensuring that documentation accurately reflects severity of illness and intensity of service • Coordinating communication with physicians. When extending an offer of employment, the University of Southern California Arcadia Hospital considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, key skills, internal peer equity, federal, State, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.
Case Manager - Care Coordination - Full Time 8 hours Day (Union, Non-Exempt) *Up to $5000 Sign On Bonus* University of Southern CaliforniaCase Manager - Care Coordination - Full Time 8 hours Day (Union, Non-Exempt) *Up to $5000 Sign On Bonus*AR$46–$76.07 / hourSpecific functions within this role include facilitation of pre-certification and payer authorization processes, facilitation of the collaborative management of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement, application of process improvement methodologies in evaluating outcomes of care support and coaching of clinical documentation efforts and serving as a clinical resource for coders, ensuring that documentation accurately reflects severity of illness and intensity of service coordinating communication with physicians. When extending an offer of employment, the University of Southern California Arcadia Hospital considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, key skills, internal peer equity, federal, State, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.
Audit and Billing Compliance Specialist University Of Arkansas SystemAudit and Billing Compliance SpecialistLittle Rock, ARPerforms specific audits outside the audit plan schedule as needed (to include, but not limited to, Office of Inspector General (OIG) audits, Medicare Administrative Contractor (MAC) audits, Recovery Audit Contractor (RAC) audits, Medicaid Integrity Contractor (MIC) audits, etc.). Department's Website: Summary of Job Duties: The Audit & Billing Compliance Specialist works under the general direction of the Clinical Billing Compliance Director and reviews medical records and billing system programs to determine coding and billing accuracy and to ensure that all federal and state guidelines for coding and billing are followed.
Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)AR$46,988–$122,400 / yearAnticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $122,400.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. Exercises independent judgement and uses available resources and technology in developing evidence, supporting allegations of fraud and abuse Required Qualifications 3 years working on health care fraud, waste, and abuse investigatory and audits required.
Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpInvestigator, Special Investigations Unit (Aetna SIU)AR$43,888–$93,574 / yearExperience with Microsoft Word, Excel, and Outlook products, open source database search tools, social media and internet research. Bachelor's Degree in Criminal Justice, Healthcare Management, Public Health, Biological Sciences, Data Analytics, or other related field preferred or equivalent experience.
Investigator, Special Investigations Unit (Meritain Health) CVS Health CorpInvestigator, Special Investigations Unit (Meritain Health)AR$46,988–$122,400 / yearDemonstrated proficiency in Microsoft Office Suite (including Excel, specifically with pivot tables), database search tools, and use of the Intranet/Internet to research information. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.