Program Management Load all Professional, Facility, and Ancillary contracts across all EmblemHealth lines of business in a timely and accurate manner. Provide subject matter expertise in all areas of contract configuration, fee schedules/groupers, and rate reimbursement. Collaborate on
The Configuration Analyst of Office365 is responsible for managing, administering and governing the Office 365 global tenants, including SharePoint Online, MS Teams, OneDrive and other applications within the Office365 suite. The resource will work in a
The Configuration & Quality Audit Manager will help build, lead and mature the new claim configuration auditing function responsible for validating accurate, complete, and compliant provider reimbursement across claims system configuration and adjudication outcomes. This role
We Breathe Life Into Data At Komodo Health, our mission is to reduce the global burden of disease. And we believe that smarter use of data is essential to this mission. That’s why we built the
EXL USA Healthcare is seeking an IRF Auditor III to join our team. This role offers a fully remote work experience with possible 10% travel per year for team meetings and limited client onsite engagements. The
Medical Biller & Coder 7 (Team D) Remote LATAM role. Compensation listed in USD with local currency equivalent. This particular role is a Peru-based independent contractor engagement. Freedom Health Systems, Inc. is a mission-driven healthcare advisory
Specialised Part-Time Consulting Opportunity for Certified Medical Coders We are sharing a specialised part-time consulting opportunity for certified medical coders with strong expertise in CPT, ICD-10, clinical documentation review, and US healthcare coding standards. This high-volume project
Specialised Part-Time Consulting Opportunity We are sharing a specialised part-time consulting opportunity for United States-based healthcare professionals experienced in clinical documentation integrity, documentation improvement, DRG accuracy, HCC risk adjustment, physician query management, coding integrity, clinical record
Essential Duties and Responsibilities: - Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data. - Enter coded data into a system
We are sharing a specialised part-time consulting opportunity for United States-based healthcare professionals experienced in clinical documentation integrity, documentation improvement, DRG accuracy, HCC risk adjustment, physician query management, coding integrity, clinical record review, and healthcare compliance
We are sharing a specialised part-time consulting opportunity for United States-based healthcare coding and risk adjustment professionals experienced in HCC coding, Medicare Advantage risk adjustment, Medicaid managed care, ACA risk adjustment, RADV audit preparation, medical record
We are sharing a specialised part-time consulting opportunity for certified medical coders with strong expertise in CPT, ICD-10, clinical documentation review, and US healthcare coding standards. This high-volume project focuses on accurately coding medical records and clinical