Assess the clinical indicators and suggestions of various query requests received from the MD Reviewer/ DRG Integrity Specialist Collaborate and communicate as necessary to clarify and avoid misinterpretation to ensure the query is optimally written and distributed to the correct client provider Creates queries in a compliant manner in accordance with AHIMA and ACDIS comp

Assigns appropriately sequenced and compliant ICD 10 CM/PCS codes as documented in the electronic medical record (EMR). Applies definition of principal diagnosis for proper assignment of MS DRGs, APR DRGs, and POA indicators using a designated encoder/grouper, while ensuring compliance with nationally established coding guidelines. Utilizes selected encoder and/or compute

At Dearborn Group, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career. Come join us and be part of a purpose driven company who is invested in your future! Job Summary Under supervision, this p

Include Ensure patient demographic information is accurate and complete Utilize customer hospital systems or approved vendors to research and obtain/verify patient demographic information Validate signature documents such as AOB (Assignment of Benefits), consents, CMN (Certificate of Medical Necessity) Verify patient name is consistent on all documents Verify date of servi

As a valued member of the DRG Review Team, the DRG Integrity Specialist performs a secondary level review of medical records and code assignment using knowledge of Accuity technology and client systems with a physician in accordance with federal coding regulations and guidelines as well as client specific coding guidelines to ensure accurate DRG assignment. This function

Performs review of the medical record including documentation, reports, flowsheets, and test results, applying evidence based criteria related to DRG and clinical validation denials Creates appeal letters utilizing the relevant information from the medical record; supported by current clinical standards and facility guidelines, evidence based medicine, professionally reco

RAYUS Radiology, formerly Center for Diagnostic Imaging and Insight Imaging, is looking for an Insurance Specialist to join our team. We are challenging the status quo by shining light on radiology and making it a critical first step in diagnosis and proper treatment. Come join us and shine brighter together! As an Insurance Specialist, you will provide expertise in insur

We have several offices in ME. All ME residents are encouraged to apply! You must have clinical experience (e.g. RN, LPN, MA, etc) to be considered! Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, p

Company Description Our Job Corps programs provide life changing services that help young people succeed in school, obtain good jobs, excel in their chosen fields, and serve as contributing members of their communities. We accomplish this through an intense commitment to safety, quality service, excellence, and partnerships. Job Description Provide information, services, a

MaineHealth is actively recruiting for a Senior Tumor Registrar role. This is a 100% remote role. Position Summary The MaineHealth Senior Tumor Registrar oversees the collection, analysis and coding of health and medical information on Maine Medical Center cancer patients and trains non certified registry staff on all of these aspects of tumor registry operations. It incl

MaineHealth is actively recruiting for a Tumor Registrar. This is a 100% remote role. Position Summary The Tumor Registrar position is responsible for the identification, collection, and management of health, medical and outcome information on all oncology patients and in accordance with established policies, procedures and regulatory requirements. Primary responsibilitie

Fully Remote Working position This position manages Revenue Integrities Clinical Data Section, which is accountable for coding and abstracting the medical records of Provider Based practice outpatient practice clinic claims i; preparing statistical analysis of medical records data; compiling, analyzing and summarizing data from medical records into various formats. The ou

Position Summary This position is the initial contact for patients with Southern Maine Medical Center, and as such must demonstrate exceptional customer service skills in all interactions. This position has the responsibility for complete and accurate patient registration, insurance verification, medical necessity validation, identifying and collecting amounts due from th

Position Summary This position is the initial contact for patients with Southern Maine Medical Center, and as such must demonstrate exceptional customer service skills in all interactions. This position has the responsibility for complete and accurate patient registration, insurance verification, medical necessity validation, identifying and collecting amounts due from th

Schedule Monday Tuesday Wednesday Thursday Friday 8 30 1 00 9 00 1 00 8 30 4 30 OFF 8 30 12 30 Position Summary The scanning Technician is responsible for scanning paper charts into the electronic medical record system. You will need to be comfortable with patient medical records management (sensitive information) and able to go into clinical areas to collect and distribu