12 jobs found in Rhode Island

Job Details Job Location Smithfield, RI - Smithfield, RI Position Type Full Time Education Level Undergraduate Certificate   Travel Percentage Occasional Job Shift Daytime Job Category Some Experience Description Position Overview The Claims Reconsideration Coder (CRC) is a multidisciplinary Certified Professional Coder accredited through the American Academy of Professional Coders or Certified Coding Specialist accredited through American Health Information Management Association. This role will evaluate medical record documentation by abstracting the pertinent information that supports the services billed to allow a determination for payment or denial on claim submissions that meet the criteria for a medical note review. Relies on sound review methods applied to the content of the medical notes, benefits, payment policies, clinical medical policies, NCCI edits, CMS, coding manuals (CPT, HCPC, ICD-10), and other industry supported resources required to...

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...

*This is NOT a remote position* Job Summary: Responsible for accurate coding of outpatient and inpatient professional services, procedures, diagnoses and conditions, working from the appropriate documentation in the medical record. Classification systems include ICD-9-CM, CPT, HCPCS as well as other specialty systems as required by diagnostic category. All work carried out in accordance with the rules, regulations and coding conventions of the American Association of Professional Coders (AAPC) ICD9 (and ICD10 when implemented), AMA CPT and CMS coding guidelines. As needed, Coders may assist and be a resource for data integrity for other employees who need clarification and assistance in coding. Duties and Responsibilities: Review medical records to identify procedures /diagnoses. Demonstrates a comprehensive, expert-level of knowledge of all procedures concerning the sequencing of diagnoses, procedures such as but not limited to those outlined in ICD-9-CM, (and ICD10 when...

Job Description Job Description SUMMARY: Under the general direction of the Manager of Revenue Cycle, performs a variety of functions related to patient accounts to ensure the financial stability of the organization. This is a full-time, 40 hours/week position (8:00AM-4:30PM Monday-Friday), at our Providence location: 110 Elm St., Providence, RI. PRINCIPAL DUTIES AND RESPONSIBILITIES: Applies the Brown Physicians Inc. values of patient care priority, dignity, collaboration, integrity and quality in support of the Brown Physicians Inc. mission to deliver compassionate, high-quality patient care, research excellence and outstanding physician education. Is responsible for knowing and acting in accordance with the Brown Physicians Inc. Compliance Program and Code of Conduct. Practices the Brown Physicians Inc. Customer Service Standards. Maintain current knowledge of federal and state regulations regarding medical billing practices. Act as a...

Job Description Job Description SUMMARY: Under the general direction of the Manager of Revenue Cycle, performs a variety of functions related to patient account charge entry. These financial transactions are to ensure stability of the organization’s accounts receivable. PRINCIPAL DUTIES AND RESPONSIBILITIES: Applies the Brown Physicians Inc. values of patient care priority, dignity, collaboration, integrity and quality in support of the Brown Physicians Inc. mission to deliver compassionate, high-quality patient care, research excellence and outstanding physician education. Is responsible for knowing and acting in accordance with the Brown Physicians Inc. Compliance Program and Code of Conduct. Practices the Brown Physicians Inc. Customer Service Standards. Maintain current knowledge of federal and state regulations regarding medical billing practices. Act as a resource to practice management and providers. Maintain knowledge of all applications including...

Job Description Job Description Seeking a Claims Reconsideration Coder for a temporary to permanent hire position with a prestigious insurance company in RI. This position is immediately available for the successful candidate. Experience is preferred; however, consideration will be given to newly certified applicants who have passed the certification exam and can present their certification number. This is a full-time position working 37 1/2 hours weekly, on site, and offers a comprehensive benefits package when/if hired permanently. Responsibilities include, but are not limited to: Responsible for all aspects of Claim Reconsideration Requests and Contracted Provider Administrative Appeals including reviewing, resolving, adjusting, and development of written communication to providers Independently abstract and interpret of all medical notes required to determine if the services billed are supported for reimbursement using current industry standard coding, CMS guidelines,...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching plans in...

Summary: Under the general supervision of the Director Imaging Operations Managers and according to established policies and procedures coordinates and directs activities of Radiologic Technologists Radiology Lead Technologists and support personnel performing a variety of duties within all departments of Diagnostic Imaging. Works in conjunction with each modality manager to coordinate staff and work assignments to provide for efficient patient flow and effective processing of diagnostic exams to the physician for use in diagnosis and treatment of patients. Ensures adherence to established standards of safety and quality. Provides functional guidance to supervisory technical and support personnel. Prepares and maintains records and reports related to activities. Responsibilities: The primary responsibility of the Supervisor is to facilitate flow throughout all imaging modalities in the Department including but not limited to: Resolves both operational and workflow issues. Assists...

JOB SUMMARY The Coding Auditor 1 is proficient in various types of coding and is responsible for performing coding quality audits and providing feedback to coders. The Coding Auditor 1 utilizes the International Classification of Disease (ICD-10-CM/PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding. Coding references will be used to ensure accurate coding and grouping of classification assignment (e.g., MS-DRG, APR-DRG, APC etc.) WORK MODEL/SALARY 100% Remote The pay range for this position is $32.02 (entry-level qualifications) - $49.63 (highly experienced) The specific rate will depend upon the successful candidate’s specific qualifications and prior experience. ESSENTIAL FUNCTIONS OF THE ROLE Performs routine coding quality reviews on all coders including third party suppliers as appropriate. Performs coding quality reviews in collaboration with or for internal...

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...

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary The Certified Professional Coder (CPC) will perform medical claim reviews to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and...

Summary: Under the general supervision of the Coding Manager and according to established procedures, accountable for assignment of diagnoses and procedures using ICD10 CM/PCS and CPT Codes. Requires knowledge of all aspects of hospital coding and strong understanding of coding guidelines. Abstracts required data into hospital information system. Ensure records are coded in an accurate and timely manner. Interprets a wide variety of clinical and diagnostic documentation, including complex medical treatment to identify diagnoses, complications, comorbidities and procedures associated with inpatient care. Education: In addition to the skills normally obtained through completion of a High School education, a Bachelor or Associates Degree is with RHIT, RHIA, preferred. Licensure: Certified Coding Specialist (CCS) is required. Experience: Three years of experience as a hospital coder. Basic computer knowledge. Meditech experience helpful, 3M experience preferred. Extensive...