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JOB DESCRIPTION: Compliance Specialist position reporting to Manager of Medical Necessity and Authorization Denials that supports quality audit of Authorization and Medical Necessity internal and vendor staff to ensure quality, appropriateness of appeals, the effectiveness of denial review, etc. Four years of administrative experience to acquire competence in applying compliance, coding, and auditing principles as they relate to insurance billing, collections, consulting, and other revenue cycle-related functions.

Duke University

Compliance Specialist

FULL_TIME

HOUR

Reviews and analyzes denied claims, prepares and submits comprehensive appeals, collaborates with physicians, Health Information Management (HIM), Case Management, Coding, Patient Financial Services, and other interdisciplinary teams to resolve denials, identify root causes and denial trends, and support denial prevention and revenue optimization initiatives. Collaborates with physicians, Physician Advisors, Coding, Clinical Documentation Integrity (CDI), Health Information Management (HIM), Case Management, Utilization Management, Revenue Integrity, Patient Financial Services, and other interdisciplinary departments to obtain supporting documentation, strengthen appeals, resolve denials, and improve reimbursement outcomes.

Northbay Healthcare

Clinical Denials Specialist (On-Site)

As 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, and life sciences companies.

Datavant

ProFee Audit Specialist- PRN

IRecruitee

Facilitate clarification to clinical documentation in the medical record; through extensive concurrent reviews with interactions with physicians, nursing staff, other interdisciplinary team caregivers and health information management coding staff, which supports appropriate acuity, resource utilization, quality, severity of illness/risk of mortality (SOI/ROM) and reimbursement. Confer with physicians face-to-face, via Epic Secure chat, phone and/or via queries to clarify information in medical record, obtain needed documentation, present opportunities and education regarding the significance of appropriate documentation needed to support the clinical severity of the patient.

Cape Fear Valley Health System

Clinical Documentation Specialist II- Full Time days

Clinical Documentation Specialist II- Full Time Days

The Patient Estimate Specialist works closely with scheduling, Patient Access, Financial Counseling, clinical departments, coding, billing, and other Revenue Cycle teams to ensure patients receive clear and accurate information regarding their anticipated financial responsibility prior to receiving services. This position serves as a subject matter resource for the Good Faith Estimate (GFE) process for uninsured and self-pay patients, as well as estimates for insured patients based on available insurance benefits, contracted rates, patient responsibility, and University Health pricing.

University Health.

Patient Estimate Specialist

As 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, and life sciences companies.

Profee Audit Specialist

Profee Audit Specialist - FT

GreenHouseAPI

Responsibilities include:Charge entry and claim submissionInsurance follow-up and payment postingReviewing and resolving claim denialsKnowledge of OB/GYN coding and billing guidelinesWorking accounts receivable and aging reportsVerifying insurance benefits and authorizationsEnsuring compliance with payor requirementsQualifications:Minimum 2 years if medical billing experience (OB/GYN preferred)Strong understanding of CPT, ICD-10, and modifiersExperience with insurance carriers, appeals and denialsAttention to detail and strong organizational skillsAbility to work independently and as part of teamCompetitive pay based on experience Please submit your resume for consideration The ideal candidate will have at least 2 years of experience in medical billing with strong knowledge of coding, insurance claims, and denial management.

West Des Moines OBGYN Associates, PC

Medical Billing Specialist

Talent Acquisition

The ideal candidate will be comfortable working in a high-volume environment, catching billing discrepancies before claims are submitted, and working closely with billing, coding, verification, authorization, and clinical teams to keep the revenue cycle moving efficiently. Join an established private healthcare practice specializing in orthopedics, spine care, sports medicine, pain management, and surgical services .

Human Hire

Charge Entry Specialist

HaleyMarketing

Identifies need to clarify documentation in records and utilizes strong communication skills with physician, physician extender, nurse or other healthcare professionals, utilizing appropriate tools to capture needed documentation. Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure.

Parkland Hospital

Health Information Management Clinical Documentation Integrity Specialist

Parkland Health

This includes greeting customers, registering patients at check-in and check out, answering telephones, scheduling appointments, cash management, and/or adiminstrative functions that support the practice's operations. Registering/scheduling patients for appointments; ensuring patient insurance eligibility through Experion, checking in patients, scanning insurance cards and ID into the EHR, and ensuring completion of all necessary paperwork.* b.

Wellstar

Front Office Specialist - Primary Care Acworth

ea_via_bold

This includes greeting customers, registering patients at check-in and check out, answering telephones, scheduling appointments, cash management, and/or adiminstrative functions that support the practice's operations. Registering/scheduling patients for appointments; ensuring patient insurance eligibility through Experion, checking in patients, scanning insurance cards and ID into the EHR, and ensuring completion of all necessary paperwork.

Front Office Specialist - West Georgia Orthopedics

Desired: BS/BA degree in health sciences or related field Formal training in decision support, databases spreadsheet, report writer, query/relational database computer software applications. As a Planetree organization, we place high value on hiring the right team to care for our patients and their families-care that is steeped in compassion, human connection, and mutual support.

Enloe Medical Center

Oncology Data Specialist - Cancer Center (Full-Time, Temporary, Days)

Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.

YEAR

Mayo Clinic

Specialist I - Inpatient Clinical Documentation Integrity (ICDI)

Screens e-faxes received, uploads documents to EHR, tasks referring provider, updates initial referral, follow up if needed, and proceeds to forward a copy of the document to HIS.Responds to inquiries regarding current status of faxes by assessing the request and evaluating the circumstances to provide regular, consistent, and timely information as needed. Documents if patient kept their appointment, reach out to specialist or facility to request visit notes or results to be e-faxed to the Referrals Department's main fax number within 5 working days of visit as needed.

San Ysidro Health Center

Referrals Specialist (San Ysidro, CA)

The Clinical Documentation Specialist is responsible for the evaluation of physician documentation utilizing their clinical expertise to ensure the patients' severity of illness is accurately portrayed in the medical record for specificity of coding and increased coding accuracy. Bachelor's degree preferred and 3 years acute health care nursing (including 1 year experience in clinical documentation), OR Associate's degree in Nursing with 5 years acute health care nursing.

Baptist Healthcare System Inc

Facility CDI Specialist

RHIT, CCS, CCSP, CPC or equivalent certifications required - Knowledge of Local Coverage Determinations and National Coverage Determinations - Professionalism in interpersonal communication skills with physicians, colleagues, and ancillary departments required - The ability to organize, prioritize, analyze, and implement daily tasks, must be a self starter and be able to work with minimal supervision - The ability to handle multiple responsibilities and tasks in stressful situations - Problem solving, analytical and critical thinking skills - The ability to maintain confidentiality, knowledge of HIPAA laws - ICD-10-CM and ICD-10 PCS trained with an accuracy rating of 95%. Day (United States of America)Coding Specialist IThe Coding Specialist I is responsible for the coding of ED, Recurring and Ancillary accounts using ICD-10-CM diagnosis and procedure codes and CPT-4 code sets.

Halifax Health

Coding Specialist I

Positions in this function investigates Optum Waste and Error stopped claims by gathering information, researching state and federal guidelines, and following internal procedure to determine the viability of the claim for further review in a production environment. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is a health care and well-being company that’s dedicated to improving the health outcomes of millions worldwide. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others.

What we do

Gain insights on how we work to help people live healthier lives and help make the health system work better for everyone by watching this video.

<a href="https://www.youtube.com/watch?v=5PbNyi2IDkY">https://www.youtube.com/watch?v=5PbNyi2IDkY</a> 

Caring. Connecting. Growing together. 

Being a part of UnitedHealth Group means working to improve health outcomes for everyone, including yourself. Here is how:

• Caring. Your total health and well-being are important to us. Whatever matters most to you — we have resources to help you be your best at work and at home. The benefits range from free Peloton courses to financial counseling. <a href="https://careers.unitedhealthgroup.com/culture/what-we-offer/">Learn more about what we offer.</a> 

• Connecting. We recognize our collective power to make an impact across our communities because we believe the health of any society is measured by the overall health of its people. <a href="https://careers.unitedhealthgroup.com/culture/">Learn more about our culture.</a> 

• Growing together. UnitedHealth Group is full of inspiring career stories, and we offer a lifetime of opportunities. <a href="https://careers.unitedhealthgroup.com/career-areas/">Discover all the ways you can learn, grow and develop.</a>

Medical Coding Specialist Jobs in the United States

Compliance Specialist Duke University

Clinical Denials Specialist (On-Site) Northbay Healthcare

ProFee Audit Specialist- PRN Datavant

Clinical Documentation Specialist II- Full Time days Cape Fear Valley Health System

Clinical Documentation Specialist II- Full Time Days Cape Fear Valley Health System

Patient Estimate Specialist University Health.

Profee Audit Specialist Datavant

Profee Audit Specialist - FT Datavant

Medical Billing Specialist West Des Moines OBGYN Associates, PC

Charge Entry Specialist Human Hire

Health Information Management Clinical Documentation Integrity Specialist Parkland Hospital

Health Information Management Clinical Documentation Integrity Specialist Parkland Health

Front Office Specialist - Primary Care Acworth Wellstar

Front Office Specialist - West Georgia Orthopedics Wellstar

Oncology Data Specialist - Cancer Center (Full-Time, Temporary, Days) Enloe Medical Center

Specialist I - Inpatient Clinical Documentation Integrity (ICDI) Mayo Clinic

Referrals Specialist (San Ysidro, CA) San Ysidro Health Center

Facility CDI Specialist Baptist Healthcare System Inc

Coding Specialist I Halifax Health

RN Clinical Reviewer (CPC Medical Coding Academy) - San Juan, PR UnitedHealth Group Inc

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