8 clinical data analyst jobs found

Professional Review Specialist II (Certified Professional Medical Coder) The Professional Review Specialist analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This is a hybrid position until fully trained. Training will be full-time onsite. Essential Functions & Responsibilities: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned Knowledge & Skills: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical terminology Knowledge of applicable fee schedule and or applicable...

divh2Coding Specialist/h2pResponsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff. This position will perform coding quality audits, provide ongoing feedback and education. This position utilizes various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment./ppstrongMinimum Qualifications:/strong/pp1. Graduate of Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience; OR Medical Coding Certification Program AND Five (5) years of coding experience; OR High School Diploma or Equivalent AND Eight (8) years of coding experience./pp2. Certification in one of the following: RHIT (Registered Health Information Technician), RHIA (Registered Health Information Administrator), COC (Certified Outpatient Coder), CCS...

Introduction Do you have experience maintaining medical records and preparing statistical reports? Join our team as a Medical Records Supervisor 1 to make a significant impact today! THE POSITION The State of Connecticut, Department of Mental Health and Addiction Services (DMHAS) is now hiring for a Medical Records Supervisor 1 to join their team! This position will help assure client charts have been maintained to The Joint Commission standards with quality, accuracy, and timeliness. HIGHLIGHTS FACILITY: Western Connecticut Mental Health Network (WCMHN) LOCATION: 95 Thomaston Ave. Waterbury, CT Please note: this position will also require travel between the Danbury and Torrington WCMHN sites. UNIT: Waterbury Administration SCHEDULE: Full-Time, 40 Hours per Week, First Shift, 8:00am - 4:30pm, Monday through Friday POSITION NUMBER: 140854 WHAT WE CAN OFFER YOU Visit our new State Employee Benefits Overview page! Professional...

The Professional Review Specialist analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This is a hybrid position until fully trained. Training will be full-time onsite. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned KNOWLEDGE & SKILLS: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical terminology Knowledge of applicable fee schedule and or applicable U&C Guidelines Proficient in Microsoft Office...

Description As the Associate Director of Medical Affairs, you will be at the forefront of engaging with the medical and scientific communities. This pivotal role focuses on establishing and maintaining relationships with leading experts in pediatric neurology and epilepsy. Reporting directly to the Medical Director of the Orphan Drug Division, you will significantly contribute to our mission of enhancing pediatric healthcare. RESPONSIBILITIES: Build and foster professional relationships with Key External Experts (KEEs) to establish robust state-level networks. Ensure the ethical and timely communication of clinical and scientific information pertaining to both marketed and pipeline compounds to healthcare providers. Collaborate effectively with colleagues to implement clinical and educational strategies, including organizing training sessions, conferences, and symposiums at medical centers and scientific congresses across the U.S. Play an influential role in...

Job Description About the Role: Join our innovative healthcare information management team as a Lead Inpatient Medical Coder. This pivotal position is essential in connecting clinical data with technology, driving the development of advanced AI solutions for medical coding and billing. You will leverage your expertise to significantly influence our product development initiatives. Requirements and Qualifications: At least 3 years of extensive experience in inpatient medical coding within a hospital setting. Expertise in accurately identifying and extracting ICD-10-CM, ICD-10-PCS, HCPCS/CPT codes, and their modifiers from patient records. Comprehensive knowledge of the evidence requirements for precise coding. Hands-on experience with grouper software for MS-DRG and APR-DRG assignment. Excellent communication skills for effective collaboration with the billing department on coding-related matters. Up-to-date with the latest ICD-10-CM,...

Job Description The purpose of this position is to apply the appropriate diagnostic and procedural codes to individual health information for data retrieval, analysis, and claims processing. The DRG coder creates consistency and efficiency in inpatient claims processing and data collection to optimize DRG reimbursement and facilitate data quality in hospital inpatient services. Responsibilities The coder abstracts pertinent information from patient records and assigns ICD-9-CM/ICD-10-CM, ICD-10-PCS or CPT/HCPCS codes, creating APC or DRG group assignments. Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. The coder keeps abreast of coding guidelines and reimbursement reporting requirements. Brings identified concerns to supervisor or department manager for resolution. Abides by the standards of Ethical Coding as set forth by the American Health Information...

Job Description About the Role: We are seeking a highly skilled and experienced Senior Inpatient HIM Coder to join our dynamic healthcare information management team. This role is crucial in bridging the gap between clinical data and technology, as we aim to develop cutting-edge AI solutions for medical coding and billing processes. The successful candidate will play a pivotal role in providing valuable insights and expertise to enhance our product development efforts. Requirements and Qualifications: A minimum of 3 years of hands-on experience as an acute HIM inpatient medical coder in a hospital environment. Proficiency in identifying and extracting ICD-10-CM, ICD-10-PCS, HCPCS/CPT codes, and associated modifiers from patient records. In-depth understanding of supporting evidence requirements for accurate coding. Practical experience using grouper software for MS-DRG and APR-DRG assignment. Strong communication skills to interact...