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

Hospital Services Technicians travel between customer healthcare facilities providing on site proactive collection and exchange of waste containers for various Stericycle programs, including but not limited to Sharps Management Service, Pharmaceutical Waste, Controlled Substances, and Document Management. This service is provided at regularly scheduled intervals for assig

Referral Coordinator The Referral Coordinator is responsible for all administrative processing in regard to patient's personal and insurance information for a group of dialysis clinics. This individual cooperates and works closely with both internal and remote co workers, possesses strong time management skills and the ability to complete assigned job duties with applicab

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

OF MINIMUM QUALIFICATIONS Education and/or experience equivalent to a bachelor's degree in science, or related field. Four (4) years of clinical data management experience. Knowledge of clinical trials data processing concepts. Demonstrated knowledge of data management processing systems. Demonstrated experience in all areas of data management database build, database main

The Certified Edit Dispute Resolution Analyst will be responsible for researching and auditing medical records for complex, diverse, multi specialty provider claims to identify and determine appropriately coded billed services when compared to the Zelis Claim Edits Product. The Certified Edit Dispute Resolution Analyst demonstrates an understanding of Zelis edits as an in

Uses electronic tracking systems to thoroughly document progress in all tasks, including retrieval of pertinent patient materials. Uses standard processes and protocols to monitor and follow up with patients, hospitals, and other parties on materials status. Collaborates with fellow Records Specialists and New Patient Coordinators to ensure seamless coverage and task mana

Medical Biller Opportunity Full Time, Onsite Pembroke Hospital is seeking Full Time Medical Biller to join our team. This is a on site position. Pembroke Hospital is a 120 bed acute care, inpatient behavioral health facility located south of Boston, in Pembroke, MA. Situated on 26 acres, we offer inpatient and partial hospitalization treatment to teens, adults and older a

The LPN/LVN is responsible for clinical functions on the unit, including all aspects of patient care incorporating the nursing process in accordance with the applicable Nurse Practice Act. The staff LPN/LVN shall ensure that the unit to which assigned shall function in a smooth, organized, and efficient manner as directed by the Registered Nurse. The provision of care inc

Clinical Informaticist, MGB Solutions Delivery, Office of the CMIO Reporting to the Brigham CMIO, The Clinical Informaticist serves as a liaison and builds collaborative relationships between informatics teams, clinicians, digital systems teams, and operational staff to ensure the optimum design/use of clinical software and workflows for patient safety, quality, patient e

Review pre bill cases simultaneously with a physician during each work shift excluding breaks and meetings to analyze and validate diagnosis and procedure codes for inpatient services via coding compliance and clinical knowledge to support accurate DRG assignment Utilizes Accuity technology for tracking of coding errors, query opportunities and other data collection as ne

Telecommute within Boston, MA/Fortune 5 Company/Excellent Compensation Package!

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

The Manager Clinical Audit provides oversight and leadership of the Clinical Audit Team within the Payment Integrity Department. The Clinical Audit team performs detailed medical record and chart audit review of the health plan's claims to ensure that all reimbursement to the provider is paid accurately. The Clinical Auditors are a liaison and resource between the health

Ensures CXM's data management activities are fully compliant with all regulatory requirements Other duties as assigned What We're Looking For Education Required BA/BS in a related field Education Desired BA/BS in a related field with strong emphasis in data analysis. Experience Required A minimum of 3 5 years of relevant work experience (i.e., data analytics informatics,