15 other jobs found in Springfield, IL

Welbehealth Pace Coding Auditor And Educator WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews...

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided to ensure correct coding guidelines are met. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure procedures meet clinical criteria and correct coding guidelines. Utilize encoders and various coding resources. Perform CPT Procedure...

Outpatient Coders Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this...

Customer Service Operations Customer Service is responsible for establishing, maintaining and enhancing customer business through contract administration, customer orders, and problem resolution. Customer Service Management is responsible for strategic oversight and leadership direction within the Customer Service function. Job Summary: The Supervisor, HCP Medical Documentation oversees the Clinical Notes Team responsible for reviewing and qualifying medical documentation to ensure compliance with insurance requirements, primarily for Continuous Glucose Monitoring (CGM) products. This role manages a team of associates who interpret clinical notes from healthcare providers, validate documentation against Medicare and insurance policies, and support the submission of claims. The Supervisor ensures timely turnaround of documentation, allocates work across multiple systems, and drives team performance through coaching, development, and accountability. Responsibilities: Directly...

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses...

What Customer Service Operations contributes to Cardinal Health Customer Service is responsible for establishing, maintaining and enhancing customer business through contract administration, customer orders, and problem resolution. Customer Service Management is responsible for strategic oversight and leadership direction within the Customer Service function. Job Summary The Supervisor, HCP Medical Documentation oversees the Clinical Notes Team responsible for reviewing and qualifying medical documentation to ensure compliance with insurance requirements, primarily for Continuous Glucose Monitoring (CGM) products. This role manages a team of associates who interpret clinical notes from healthcare providers, validate documentation against Medicare and insurance policies, and support the submission of claims. The Supervisor ensures timely turnaround of documentation, allocates work across multiple systems, and drives team performance through coaching, development, and...

WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews Oversee audits and participate...

Become a part of our caring community and help us put health first 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. 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...

Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses using a standardized system, ensuring...

Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. What We’re Looking For We’re looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for...

SPECIALTY SCOPE FOR THIS CODER II POSITION TO INCLUDE BUT NOT LIMITED TO: Upper Extremity Shoulders: Total/Hemi Arthroplasty, Arthroscopy, Rotator cuff repair, Biceps tenodesis, Acromioplasty, Distal claviculectomy, Superior Labrum Anterior to Posterior tear (SLAP) repair Elbows: Cubital tunnel release, Bursectomy, Arthroplasty Wrist: Carpal tunnel release, Carpectomy, TFCC debridement/repair, 4-corner fusion, De Quervain (1st dorsal compartment) Hands: Trigger fingers, Ganglions, Mallet fingers, Carpometacarpal (CMC) arthroplasty, Dupuytren's (Palmar fascial fibromatosis), Amputations Lower Extremity Hips: Dislocation reductions, Total/partial Arthroplasty, Femoral fracture treatments, Arthroscopy Pelvis: Fracture repairs Femur: ORIF neck fractures, Trochanteric repairs, shaft fracture repairs Knees: Dislocation repairs/reductions, Total/hemi arthroplasty, Meniscal repairs, Ligamentous reconstructions and repairs, Arthroscopy Tibia/Fibula: Plateau repairs, shaft Fracture...

About Otsuka We defy limitation, so that others can too. In going above and beyond—under any circumstances—for patients, families, providers, and for each other. It’s this deep-rooted dedication that drives us to uncover answers to complex, underserved medical needs, so that patients can push past the limitations of their disease and achieve more than they thought was possible each day. About the Role The Omnichannel Center of Excellence is dedicated to driving innovation, building, and delivering capabilities that enhance Otsuka’s opportunity to make an impact in the lives of those we serve. We achieve this through our relentless focus on customer centricity, patient empathy, expertise in enabling pathways for disease education and awareness of management options, and our unwavering commitment to supporting access to treatment. We are looking for an Omnichannel Data Scientist, Medical Omnichannel with strong expertise in artificial intelligence, encompassing machine learning,...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Eligibility on day 1 for all benefits Dollar-for-dollar 401(k) match, up to 5% Debt-free tuition assistance, offering access to many no-cost and low-cost degrees, certificates and more Immediate access to time off benefits At Baylor...

Software Guidance & Assistance, Inc., (SGA), is searching for a HIM Inpatient Coder for a Contract assignment with one of our premier Healthcare clients in Chicago, IL.(% remote)Responsibilities :Assigns ICD CM-PCS and / or CPT- diagnostic and procedure codes to patient charts with accuracy and attention to detailAbstracts selected data items and enters in M encoder / Epic software with accuracy and attention to detailCompletes UHDDS data abstraction as requiredMaintains a log of work performedCompletes other assigned duties as directed by managementRequired Skills :Knowledge :RHIA, RHIT, and / or CCS CertificationMinimum years' experience Inpatient medical record codingTrauma and / or Research University ExperienceKnowledge of medical terminology and anatomy and physiology requiredWindows applications, Outlook, WebEx and other apps as needed to perform roleAbility to concentrate on task at hand in open distracting environment independent manner; minimizing distractions in...

We are seeking experienced and highly accurate Value-Based Coders to join a project dedicated to in-home health assessments for Medicare Advantage and other value-based programs.This role is 100% remote and ideal for coders who are confident working independently, detail-oriented, and committed to quality and compliance.As a contractor, you'll have the independence to manage your own schedule while contributing to meaningful work that truly makes a difference.As part of the coding team, you will review clinical documentation from in-home visits and assign complete and compliant ICD-10-CM diagnosis codes that reflect the full spectrum of each patient's health.This includes :Risk adjustment (HCC) diagnoses aligned with CMS-HCC and HHS-HCC models.Social Determinants of Health (SDOH) codes.Medication-related Z codes, such as long-term drug therapy and treatment monitoring.All other clinically relevant diagnoses supported by documentation.Your accuracy directly supports the integrity of...