Fidelis Care

Job Description:You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Must be willing to travel to NYC twice a year for required meetings. Position Purpose:The focus of this position is to establish processes to respond to ICD-10 coding changes and its effect on inpatient claims payment. Chart review will include DRG pre-payment review, hospital readmission review and outlier payment review.Analyze moderately complex health care information; reviews medical records; integrate medical coding and reimbursement rules; provide pricing guidance.Ensure medical coding rules and regulations including compliance requirements are adhered to for the appropriate handling of medical necessity, claims denials, and bundling issues.Provide regular reports on project...

Job Description:You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Responsible for developing, conducting, administering, and analyzing clinical coding training and auditing programs. The Senior Clinical Coding Auditor & Trainer will conduct audits of inpatient coding processes for Fidelis Care and assist in development of training and audit tools. The Senior Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis. Candidates must be willing to travel to New York twice a year to be considered for the position. Responsibilities: Develop and maintain complex audit processes and audit tools related to inpatient coding Develop and conduct clinical education courses for...