The DRG Validation Nurse Reviewer will be primarily responsible for conducting post service, pre payment and post pay comprehensive inpatient DRG reviews based on industry standard inpatient coding guidelines and rules, evidence based clinical criteria plan, and policy exclusions. Conduct reviews on inpatient DRG claims as they compare with medical records ICD 10 Official

To set up invoices for paper and electronic submission to responsible party Resolve billed client invoices by contacting both internal and external clients. Calculate payable portion per applicable contract and utilize available tools to secure proper payment from payer. This includes contacting payer as needed and reviewing contract and billing terms. Coordinate daily wo

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

Analyzes, prepares, sorts and scans medical record documents into the document management system making certain all documentation scanned belongs in the appropriate patient's medical record. Prepares batches of documents according to established prepping guidelines and scans within specified time frames while meeting productivity & accuracy expectations. Performs a qualit

Are you a current UMass Memorial Health caregiver? CLICK HERE to apply through your Workday account. Schedule Details Friday, Holidays No More Than Every Third Holiday, Monday, Saturday, Sunday, Thursday, Weekends Every Weekend Scheduled Hours 8 4 30pm Shift 1 Day Shift, 8 Hours (United States of America) Hours 40 This position may have a signing bonus available a member

Ready to help us transform healthcare? Bring your true colors to blue. Position Summary This position does require travel within Massachusetts. This role will be responsible for representing Blue Cross Blue Shield MA's risk adjustment coding improvement initiatives through engagement with health care providers and non clinical team members. Collaborates with internal team

Use/s the Mass General Brigham values to govern decisions, actions, and behaviors. These values guide how we get our work done Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collab

Great opportunity to join an experienced team supporting transitioning planning for medical/surgical inpatients. Role requires ability to work independently and ability to prioritize tasks. Work closely with members of the care team interact with patients good communication skills and ability to use computer are key Supports the Case Manager in coordinating, negotiating,

Under the direction of the Medical Records Supervisor, the HIM Specialist I provides support to the Medical Records department by scanning documents into the Electronic Medical Record (EMR) and routing scanned information to the appropriate provider. In addition, the HIM Specialist I will respond to requests for medical records by releasing/obtaining records when appropri

Pre Analytical Assistant I Marlborough, MA Pre Analytical Assistant I is responsible for general support functions within the Technical Operations Department. Pay Range $18.61+ per hour Salary offers are based on a wide range of factors including relevant skills, training, experience, education, and where applicable, certifications obtained. Market and organizational fact

Under the supervision of the Directors of Patient Services and the Referral Supervisor, the Referral Coordinator is responsible for the processing of insurance referrals, professional communication with both internal and external clients, the registration and documentation of patients at check in as needed, and the provision of excellent customer service. Representative D

We're saving lives, building careers, and reimagining healthcare. We can't wait to grow alongside you. Job Profile Summary This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing . In addition, this role focuses on performing the following Patient Access duties Performs the administrative and financial cleara

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,

Lab Assistant I Marlborough, MA Sunday Thursday 10 00pm 6 00am Lab Assistant I is responsible for general support functions within the Technical Operations Department. Pay Range $18.61+ per hour Salary offers are based on a wide range of factors including relevant skills, training, experience, education, and where applicable, certifications obtained. Market and organizati

Lab Assistant I Marlborough, MA Monday Friday (Rotational Weekends 8 00pm 4 00am) Lab Assistant I is responsible for general support functions within the Technical Operations Department. Pay Range $18.61+ per hour Salary offers are based on a wide range of factors including relevant skills, training, experience, education, and where applicable, certifications obtained. Ma