Parkland Health
Remote Jobs
6 Jobs
The primary purpose involves conducting audits of medical record coding to ensure compliance with established guidelines, providing audit results, and assisting with educational activities related to findings to promote adherence to state/federal laws and regulatory requirements. Responsibilities include quality reviews on all coders using official guidelines and providing feedback to management and coders.
This role oversees medical coordination for utilization and quality management within the health plan network, supporting clinical activities across UM, Quality, Policy, and Population Health functions. Responsibilities include reviewing utilization requests, participating in process improvement, ensuring regulatory conformance, and providing clinical oversight for various management activities.
The specialist reviews coding quality alerts and billing edits for various encounters, ensuring accuracy before final billing, and evaluates coding denials to identify areas for revenue cycle improvement. Responsibilities also include assigning appropriate diagnosis and procedure codes according to ICD conventions and guidelines, and assisting in resolving billing edits holding patient claims.
As a part of our Coding Quality team, our coding editors play an integral role in reviewing coding quality alerts and/or billing edits for hospital, outpatient, and ambulatory encounters. This team will also review coding denials and evaluate areas of improvement throughout the r...
PCHP - Parkland Community Health Plan Remote PRIMARY PURPOSE Oversees medical coordination required for effective utilization and quality management of the health plan network. Supports the clinical activities of PCHP Utilization Management, Quality Management, Clinical Policy, T...
Conducts audits of medical record coding to ensure compliance with established guidelines, provides results of audits, and assists with educational activities related to findings to promote adherence to state/federal laws and regulatory requirements. Conducts quality reviews on a...
