Clinical Coder Specialist
3 days ago
Pacer Staffing is seeking a skilled Clinical Coder to join our team. As a Clinical Coder, you will be responsible for conducting retrospective medical claim reviews and adjudication for coding determinations.
Key Responsibilities:- Claims Coding Reviews: Perform claims coding reviews using current coding guidelines to ensure accuracy and compliance.
- Focused Claims Reviews: Conduct focused claims reviews as requested by management and summarize findings to identify potential issues.
- Quality Assurance: Identify and report potential fraudulent or quality issues to ensure the integrity of our claims process.
- Coding Expertise: Serve as a resource for Pacer Staffing staff on ICD-10-CM, HCPCS, and CPT coding to ensure consistency and accuracy.
- Research and Analysis: Research TRICARE manuals for benefits, limitations, exclusions, and current coding guidelines to stay up-to-date on industry developments.
- Timeliness and Compliance: Monitor and track timeliness of retrospective claims reviews to ensure compliance with required timelines.
- Review and Escalation: Identify questionable review decisions and escalate to the appropriate Medical Director for evaluation and/or corrective action.
- Data Entry and Management: Provide accurate data entry in medical management and claims systems to ensure seamless data flow.
- Additional Responsibilities: Perform other duties as assigned to support the success of our team.
- Availability: Availability to work any shift to meet the needs of our clients.
- Work Environment: Works within a standard office environment, with minimal travel required.
- Computer Work: Extensive computer work with prolonged sitting to ensure efficient data entry and management.
- Certification: Current Certification as a Professional Coder (CPC) or Certified Professional Coder Hospital (through the American Academy of Professional Coders).
- U.S. Citizenship: If supporting TRICARE contract, must be a U.S. Citizen.
- Background Investigation: If supporting TRICARE contract, must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation.
- Experience: 2+ years of clinical coding experience and 2+ years of claims processing experience.
- Preferred Qualifications: Experience in the private medical industry, health insurance, or Managed Care field; experience in a fast-paced corporate environment; familiarity with TRICARE and the military healthcare delivery system.
- Technical Skills: Knowledge of ICD-10, HCPCS, and CPT coding; ability to maintain the confidentiality and security requirements of medical records; ability to meet department performance standards.
-
Clinical Coding Specialist
7 days ago
Atlanta, Georgia, United States Pacer Staffing Full timeJob Summary:Pacer Staffing is seeking a skilled Clinical Coding Specialist to join our team. As a Clinical Coding Specialist, you will be responsible for conducting retrospective medical claim reviews and adjudication for coding determinations.Key Responsibilities:Claims Coding Reviews: Perform claims coding reviews using current coding guidelines to ensure...
-
Clinical Coding Specialist
2 weeks ago
Atlanta, Georgia, United States Pacer Staffing Full timeJob SummaryPacer Staffing is seeking a skilled Clinical Coding Specialist to join our team. As a Clinical Coding Specialist, you will be responsible for conducting retrospective medical claim reviews and adjudication for coding determinations.Key ResponsibilitiesClaims Coding Reviews: Perform claims coding reviews using current coding guidelines to ensure...
-
Clinical Coding Specialist
2 weeks ago
Atlanta, Georgia, United States Pacer Staffing Full timeJob SummaryPacer Staffing is seeking a skilled Clinical Coding Specialist to join our team. As a Clinical Coding Specialist, you will be responsible for conducting retrospective medical claim reviews and adjudication for coding determinations.Key ResponsibilitiesClaims Coding Reviews: Perform claims coding reviews using current coding guidelines to ensure...
-
Inpatient Professional Coder
1 week ago
Atlanta, Georgia, United States TTS Technologies Full timePosition Title: Inpatient Profee CoderContract Type: 1+ year Contract or Contract-to-Hire (full time only)Work Environment: 100% RemoteRole Overview: The Inpatient Profee Coder will be responsible for accurately coding inpatient professional services. This role requires a keen understanding of medical coding guidelines and regulations to ensure compliance...
-
Certified Coder
4 days ago
Atlanta, Georgia, United States Rose International Full timeJob SummaryRose International is seeking a highly skilled RN Certified Coder to join our team. As a key member of our healthcare team, you will be responsible for determining the correct codes for language in benefit plans, reviewing peer designations, and facilitating discussions to create a coding document.ResponsibilitiesCoding and Reimbursement:...
-
Inpatient Medical Coder
2 weeks ago
Atlanta, Georgia, United States Franciscan Missionaries of Our Lady Health System Full timeAbout UsFranciscan Missionaries of Our Lady Health System is a prominent healthcare organization dedicated to providing exceptional medical services across Louisiana and Mississippi. Our extensive network of hospitals, clinics, and healthcare professionals allows us to deliver quality care to a significant portion of the population in these regions. By...
-
Continuum Care Support Specialist
2 weeks ago
Atlanta, Georgia, United States Kaiser Permanente Full timeJob Overview:The Continuum Care Coordinator plays a pivotal role in managing non-clinical operations within the healthcare continuum. This position is essential in assisting Case Managers and Physicians with their daily responsibilities, ensuring the accuracy and integrity of data across all inpatient and outpatient services. The coordinator is responsible...
-
Continuum Care Management Specialist
1 week ago
Atlanta, Georgia, United States Kaiser Permanente Full timePosition Overview:The Continuum Care Coordinator plays a vital role in overseeing non-clinical operations within the healthcare continuum. This position is essential in aiding Case Managers and Physicians in their daily functions, ensuring the accuracy and integrity of data across both inpatient and outpatient services. The Coordinator is responsible for the...
-
Continuum Care Specialist
2 weeks ago
Atlanta, Georgia, United States Kaiser Permanente Full timeJob Overview: The Continuum Care Coordinator plays a vital role in facilitating non-clinical operations across the healthcare continuum. This position is essential in assisting Case Managers and Physicians with their daily responsibilities, ensuring the accuracy and integrity of data related to inpatient and outpatient services. The coordinator is...
-
Continuum Care Support Specialist
2 weeks ago
Atlanta, Georgia, United States Kaiser Permanente Full timeJob Overview:The Continuum Care Coordinator plays a vital role in managing all non-clinical operations within the Continuum framework. This position is essential in assisting Case Managers and Physicians with their daily tasks, ensuring the accuracy and integrity of data across both inpatient and outpatient services. The Coordinator is responsible for the...
-
Continuum Care Management Specialist
1 week ago
Atlanta, Georgia, United States Kaiser Permanente Full timeJob Overview: The Continuum Care Coordinator plays a pivotal role in facilitating all non-clinical operations within the Continuum framework. This position is essential in assisting Case Managers and Physicians with their daily tasks, ensuring the accuracy and integrity of data related to both inpatient and outpatient services. The coordinator is responsible...
-
Healthcare Recruitment Specialist
2 weeks ago
Atlanta, Georgia, United States Clinical Management Consultants Full timeJob OverviewAn exceptional opportunity awaits for a Healthcare Recruitment Specialist within a dynamic environment.In this engaging and fast-paced position, the Healthcare Recruitment Specialist will spearhead recruitment strategies, create compelling employment marketing materials, conduct interviews with healthcare professionals, and collaborate with...
-
Healthcare Recruitment Specialist
1 week ago
Atlanta, Georgia, United States Clinical Management Consultants Full timeJob OverviewAn exciting opportunity has arisen for a Healthcare Recruitment Specialist to contribute to the dynamic field of healthcare staffing.Role ResponsibilitiesIn this fast-paced and rewarding position, the Healthcare Recruitment Specialist will lead recruitment initiatives, create engaging employment marketing materials, conduct interviews with...
-
Healthcare Recruitment Specialist
1 week ago
Atlanta, Georgia, United States Clinical Management Consultants Full timeJob OverviewAn exceptional opportunity awaits for a Healthcare Recruitment Specialist to thrive in a dynamic and rewarding environment.This role involves crafting and implementing effective recruiting strategies, producing engaging employment marketing materials, conducting interviews with healthcare professionals, and collaborating with hospital clients...
-
Clinical Oncologist specializing in Sarcoma
1 week ago
Atlanta, Georgia, United States American Society of Clinical Oncology (ASCO) Full timePOSITION: MEDICAL ONCOLOGIST - SARCOMA SPECIALISTORGANIZATION: AMERICAN SOCIETY OF CLINICAL ONCOLOGY (ASCO)The American Society of Clinical Oncology (ASCO) is seeking a board-certified Medical Oncologist with a specialization in sarcoma, dedicated to the management of adult patients suffering from bone and soft tissue malignancies. This role will involve...
-
Clinical Immunohematology Specialist
2 weeks ago
Atlanta, Georgia, United States Americasblood Full timeClinical Immunohematology Specialist Position Organization: Americasblood Location: Remote Americasblood is seeking a skilled Clinical Immunohematology Specialist to become a vital member of our dedicated laboratory team. This role is essential for ensuring the safety and quality of blood products through rigorous testing and analysis. Key...
-
Clinical Nurse Specialist
2 days ago
Atlanta, Georgia, United States Enterprise Solutions Inc. Full timePosition Title: Clinical Nurse Specialist - Medical / SurgicalWe are seeking a qualified Clinical Nurse Specialist with expertise in Medical/Surgical care. Candidates must have proficiency in EPIC and a strong background in M/S nursing.Essential Candidate Qualifications: A comprehensive Work History/Resume demonstrating no employment gaps exceeding 60 days,...
-
Clinical Appeals Specialist
5 hours ago
Atlanta, Georgia, United States Piedmont Healthcare Corporate Full timeAbout the Role:Piedmont Healthcare Corporate is seeking a skilled Clinical Appeals Specialist to join our team. As a Clinical Appeals Specialist, you will be responsible for reviewing and analyzing clinical information from patient medical records to draft effective narratives for Medicare and Medicaid appeals documentation and briefs.Key...
-
Clinical Logistics Nurse
5 days ago
Atlanta, Georgia, United States Core Clinical Management LLC Full timeJob Description**Job Summary:**We are seeking a highly skilled Clinical Logistics Nurse to join our team at Core Clinical Management LLC. As a Clinical Logistics Nurse, you will play a critical role in improving the quality and efficiency of care for hospitalized patients.Key Responsibilities:Process Improvement: Collaborate with Medical Directors to develop...
-
Clinical Nutrition Specialist
2 weeks ago
Atlanta, Georgia, United States TotalMed Staffing Full timeClinical Nutrition Specialist Job ID #1592252 | Share About this Role Job details $1,599.60 / week Atlanta, Georgia New Profession: Clinical Nutrition Specialist Facility Type: ??? Specialty: Clinical Nutrition Division: TotalMed Staffing Shift: 7:00 AM - 3:30 PM, 5 day(s)/week Key Responsibilities - Assess and evaluate patients' nutritional needs. -...