13 compliance analyst jobs found in Springfield

Job Description Job Description Description: About the Company: NextStep Technology Inc. is seeking a Medical Records Analyst. The medical records analyst is primarily responsible for review of health information. The MRA reviews the medical records for specific criteria and validation of specific code year sets submitted from selected organizations to government and commercial client. The position requires review of protected health information and must maintain strict confidentiality when addressing or referring to such records. The incumbent must have the ability to use a variety of office equipment, computer software, the ability to use sound and professional judgement, and to work independently. The candidate(s) will be hired as an employee up to 40 hours per week (flexible scheduling). This is a remote position About the Role: The medical records analyst is primarily responsible for review of health information. Responsibilities: Analyze protected...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $24.65 - $27.10/hr based on experience We are seeking candidates with experience in at least one of the following; Cardiology, Ortho, Podiatry, Radiology Oncology, OBGYN, Gynecology Oncology, Behavioral Health, RHC, Urology, Nephrology, Vascular, Neurosurgery and General Surgery. The Forensic Coder is a certified coder with expert knowledge in front and back end coding. This position is responsible for root cause analysis of trending front and/or back end identified coding opportunities; internal and external coding/documentation education; supporting and at times leading coding opportunity improvement projects. This position will also perform and/or assist with special coding projects as determined by leadership. Job Responsibilities: Complete root cause analysis of...

Job Description Job Description CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Provides guidance and leadership to coding and billing management in the implementation and administration of effective systems, processes, and procedures. Performs annual performance reviews and quality assurance reviews to assess comprehension of training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $24.65 - $27.10/hr based on experience We are seeking candidates with experience in at least one of the following; Cardiology, Ortho, Podiatry, Radiology Oncology, OBGYN, Gynecology Oncology, Behavioral Health, RHC, Urology, Nephrology, Vascular, Neurosurgery and General Surgery. The Forensic Coder is a certified coder with expert knowledge in front and back end coding. This position is responsible for root cause analysis of trending front and/or back end identified coding opportunities; internal and external coding/documentation education; supporting and at times leading coding opportunity improvement projects. This position will also perform and/or assist with special coding projects as determined by leadership. Job Responsibilities: Complete root cause analysis of...

Job Description Job Description CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Provides guidance and leadership to coding and billing management in the implementation and administration of effective systems, processes, and procedures. Performs annual performance reviews and quality assurance reviews to assess comprehension of training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $24.65 - $27.10/hr based on experience We are seeking candidates with experience in at least one of the following; Cardiology, Ortho, Podiatry, Radiology Oncology, OBGYN, Gynecology Oncology, Behavioral Health, RHC, Urology, Nephrology, Vascular, Neurosurgery and General Surgery. The Forensic Coder is a certified coder with expert knowledge in front and back end coding. This position is responsible for root cause analysis of trending front and/or back end identified coding opportunities; internal and external coding/documentation education; supporting and at times leading coding opportunity improvement projects. This position will also perform and/or assist with special coding projects as determined by leadership. Job Responsibilities: Complete root cause analysis of...

Job Description Job Description CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Provides guidance and leadership to coding and billing management in the implementation and administration of effective systems, processes, and procedures. Performs annual performance reviews and quality assurance reviews to assess comprehension of training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is...

Job Overview This Third-Party Billing and Follow-Up Representative facilitates billing and collection processes for outstanding accounts receivable. The role analyzes claims, confirms demographics and billing information, recommends improvements to billing and collection practices, processes legal requests for information, and ensures compliance with local and federal regulations. Responsibilities Facilitate billing and collection processes for outstanding accounts receivable. Communicate with internal and external contacts to resolve billing, collection, and claims, including Medicare and other government and non-government accounts. Monitor daily queue performance, maintain acceptable levels, and alert management of high call volume patterns. Handle incoming and outgoing billing correspondence and phone inquiries related to patients, third-party administrators, attorneys, vendors, and insurance payers. Document conversations and actions taken to support all claims...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Memorial Health System in Springfield, IL is seeking a Billing Specialist to analyze, investigate, and resolve complex medical claims and related billing information, ensuring accuracy and compliance with managed care guidelines and MMC policies. The role requires attention to detail, strong problem solving and communication skills, and the ability to work with internal departments and external payors to secure timely reimbursements. #J-18808-Ljbffr

Position Summary: Analyzes, investigates, and resolves claims/billing information and/or errors associated with the more complex inpatient/outpatient medical insurance claims. Ensures compliance with managed care guidelines and MMC organizational policies. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values. USD $18.34/Hr. Max USD $28.42/Hr. Overview Position Summary: Analyzes, investigates, and resolves claims/billing information and/or errors associated with the more complex inpatient/outpatient medical insurance claims. Ensures compliance with managed care guidelines and MMC organizational policies. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values. Qualifications Education: Education equivalent to graduation from high school or GED is required. Experience...

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 115,000 colleagues serve people in more than 160 countries. Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and family, be your true self and live a full life. You will also have access to: Career development with an international company where you can grow the career you dream of. Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. An excellent retirement savings plan with high employer contribution Tuition reimbursement, the Freedom 2 Save student debt program and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree. A company...