Clinical Coding Analyst RN, Senior
21 hours ago
Your Role
The Facility Compliance Review team reviews post service prepayment facility claims for contract compliance, industry billing standards, medical necessity and hospital acquired conditions/never events.. The Certified Clinical Coder Nurse, Senior will report to the Senior Manager, Facility Compliance Review. In this role you will be performing in-depth quality audits of hospital claims to support ICD-10-CM and ICD-10 PCS codes as well as MS-DRG and APR-DRG reviews based on clinical determination. You will review claims for medical necessity and to meet the criteria for the coding billed. You will also be responsible for reviewing outpatient coding for appropriateness of billing related to injection and infusions. Review medical records and perform coding analysis on all diagnoses, procedures, DRG/APC and charge codes. Ensure that the billed coding is appropriate based on reimbursement requirements, research, epidemiology, financial and strategic planning and evaluation of quality of care. The ideal candidate will hold at least a CPC or CCS certification from AHIMA or AAPC, and higher-level certifications are highly desirable.
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Clinical Coding Analyst RN, Senior
22 hours ago
Long Beach, United States Blue Shield of California Full timeThe Facility Compliance Review team reviews post service prepayment facility claims for contract compliance, industry billing standards, medical necessity and hospital acquired conditions/never events.. The Certified Clinical Coder Nurse, Senior will Clinical, Analyst, RN, Senior, Insurance, Healthcare
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Clinical Coding Analyst RN, Senior
23 hours ago
Long Beach, United States Blue Shield of California Full timeThe Facility Compliance Review team reviews post service prepayment facility claims for contract compliance, industry billing standards, medical necessity and hospital acquired conditions/never events.. The Certified Clinical Coder Nurse, Senior will Clinical, Analyst, RN, Medical Director, Senior, Compliance, Insurance, Healthcare
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Clinical Coding Analyst RN, Senior
24 hours ago
Long Beach, United States Blue Cross and Blue Shield Association Full timeYour Role The Facility Compliance Review team reviews post service prepayment facility claims for contract compliance, industry billing standards, medical necessity and hospital acquired conditions/never events.. The Certified Clinical Coder Nurse, Senior will report to the Senior Manager, Facility Compliance Review. In this role you will be performing...
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Clinical Coding Analyst RN, Consultant
22 hours ago
Long Beach, United States Blue Shield of California Full timeThe Facility Compliance Review team reviews post service prepayment facility claims for contract compliance, industry billing standards, medical necessity and hospital acquired conditions/never events.. The Certified Clinical Coder Nurse, Lead/ Consu Clinical, Consultant, Analyst, RN, Medical Director, Compliance, Insurance, Healthcare
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Clinical Coding Analyst RN, Consultant
22 hours ago
Long Beach, United States Blue Cross and Blue Shield Association Full timeYour Role The Facility Compliance Review team reviews post service prepayment facility claims for contract compliance, industry billing standards, medical necessity and hospital acquired conditions/never events.. The Certified Clinical Coder Nurse, Lead/Consultant will report to the Senior Manager, Facility Compliance Review. In this role you will be...
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Data Analyst
1 hour ago
Long Beach, California, United States Blue Shield of California Full timeCompany Overview:Blue Shield of California is a leading healthcare organization that delivers best-in-class clinical quality analytics and informatics to enable high-quality and affordable member-centered care.About the Role:We are seeking an experienced Data Analyst - Clinical Quality Senior to join our team. This role will provide data, analytic, and...
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Clinical Quality Analytics, Senior
1 week ago
Long Beach, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
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Clinical Quality Analytics, Senior
2 months ago
Long Beach, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
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Clinical Quality Analytics, Senior
2 weeks ago
Long Beach, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
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Clinical Quality Analytics, Senior
1 week ago
Long Beach, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
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Clinical Quality Analytics, Senior
1 month ago
Long Beach, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
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Clinical Quality Analytics, Senior
2 months ago
Long Beach, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
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Clinical Quality Analytics, Senior
1 month ago
Long Beach, United States Blue Shield of California Full timeYour RoleThe Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
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Clinical Quality Analytics, Senior
1 month ago
Long Beach, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
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Clinical Quality Analytics, Senior
1 month ago
Long Beach, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
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Clinical Quality Analytics, Senior
4 weeks ago
Long Beach, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
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Clinical Quality Analytics, Senior
1 month ago
Long Beach, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
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Clinical Quality Analytics, Senior
2 weeks ago
Long Beach, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
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Clinical Quality Analytics, Senior
2 weeks ago
Long Beach, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
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Clinical Quality Analytics, Senior
2 weeks ago
Long Beach, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...