Codes and abstracts Inpatient records for data retrieval, analysis, reimbursement and research.
Codes diagnostic and procedure codes into a designated coding and abstracting system utilizing the 3M encoder, as appropriate.
Meets quality and productivity coding standards and demonstrates the ability to navigate an EMR.
CommonSpirit Health is committed to building healthy communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen both inside our hospitals and out in the community. With more than 700 care sites across the U.S., CommonSpirit is accessible to nearly one out of every four U.S. residents.
The Hospital Contract Definition Analyst plays a critical role in the implementation and maintenance of hospital payer contracts within Experian Health's Contract Manager system.
You will ensure accurate modeling of reimbursement methodologies to support valuation of hospital claims and patient estimates and collaborate with senior team members to process new client implementations.
Independently manages routine maintenance cases, ensuring compliance with enterprise standards and client expectations.
Experian is a global data and technology company, powering opportunities for people and businesses around the world. A FTSE 100 Index company listed on the London Stock Exchange (EXPN), they have a team of 23,300 people across 32 countries where their corporate headquarters are in Dublin, Ireland.
Interpret and apply CMS, Medicare, Medicaid, and AMA policies to define claims editing logic.
Analyze claims and edit performance data to confirm accuracy and prioritize enhancements.
Monitor regulatory updates and coding changes to keep edits current and compliant.
Machinify is a leading healthcare intelligence company that delivers value, transparency, and efficiency to health plan clients. They use an AI-powered platform with expertise across the payment continuum, serving over 85 health plans and 270 million lives.
Accurately assign ICD-10-CM, CPT, and HCPCS codes for Behavioral Health and SUD services.
Review clinical documentation to ensure coding accuracy and compliance.
Stay current with coding updates, payer policies, and regulatory changes.
Steadfast Health is dedicated to setting a new standard of care for substance use disorder (SUD) treatment. They are rapidly growing and building a dedicated team of professionals, focused on low-barrier, high-quality care accessible to all.
Responsible for the review and update of existing concepts based upon required periodic review cycle or as needed based upon client or regulatory changes.
Collaborates with and leverages Segment Specialist expertise to ensure on-point results and ensure training material updates as necessary.
Conduct research, identify impact on existing concepts, and document accordingly and support activities required to package concepts.
Machinify is a healthcare intelligence company that delivers value, transparency, and efficiency to health plans. They are deployed by over 75 health plans, representing more than 170 million lives, and use an AI operating system, combined with expertise, to untangle healthcare data.