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Knowledge and experience working with industry standard coding dictionaries, e.g. MedDRA, WHODrug. Defining and delivering reporting content for use in managing clinical trial conduct in collaboration with other Clinical Operations and Clinical Data Management roles, Medical Monitors, Translational Medicine, Clinical Pharmacology, Biostatistics, and other internal and external stakeholders.
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Collaborates with Government Regulatory Affairs, Network Management, Medical Economics, Benefit Administration, Provider Services, Audit, IT and Claim Operations to determine the impact of implementing policy changes.
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Medical Director - Southeast Region - Work from Home at Humana in Boise, Idaho, United States Job Description Become a part of our caring community and help us put health first The Medical Director relies on medical background and reviews health claims.
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If you are interested in developing leadership skills while deepening your understanding of coding and revenue cycle One Medical, we’d love to hear from you! Possesses advanced knowledge and understanding of HCC Risk Adjustment, coding and documentation requirements.
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He/she will need to maintain medical knowledge as required by the role, strong and current knowledge of drug safety and pharmacovigilance regulations, pharmacovigilance practices, safety surveillance and risk-management practices.
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The MGPO Professional Billing Office is the central billing office for physician practices affiliated with Partners Healthcare members including the Massachusetts General Hospital in Boston, Massachusetts, Newton Wellesley Hospital and North Shore Medical Center.
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Position responsibilities include overseeing risk capture performance, reporting and assisting with the following: coding, abstracting and analyzing/reviewing medical records for the PHO risk adjustment programs to ensure proper medical diagnoses are coded appropriately and that the members medical record documentation supports the codes accurately in accordance with CMS, CPT and ICD.10 guidelines.
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The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value based care, population health, or disease or care management.
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Experience with medical coding systems (e.g., NDC, ICD-9, HCPCS/CPT, SNOMED CT, LOINC), basic medical terminology, and epidemiologic principles a must. Experience analyzing large administrative healthcare data a must (Medicare/Medicaid, other claims-based or electronic medical records databases.
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1+ years of hands-on work experience coding with data visualization platform (Tableau, Spotfire, etc.) 1+ years of hands-on work experience coding with modern web apps (e.g., React) At 1910 Genetics, we put computation at the heart of drug discovery, blending expertise in computational chemistry, structural biology, pharmacology, genetics, data science, and software engineering to develop drugs for previously undruggable targets.
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Proficiency with data visualization or mapping using Tableau, ArcGIS, or coding languages. Health and Welfare: Comprehensive medical, dental, and vision benefits, disability and life insurance programs, along with voluntary benefits.
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Demonstrated proficiency in drug safety databases (e.g., Argus), electronic data capture systems, and coding with MedDRA and WHO Drug dictionary. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law.
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Med Tech's perform and evaluate complex laboratory tests in various areas of the clinical laboratory.
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This is an opportunity to join a dynamic team as an Engineer I, Medical Device at a venture backed Medical Device organization, reporting directly to the CTO. The successful candidate will drive key activities throughout the development phases of the combination product as well as transitioning the design to large-volume manufacturing, and facilitate the deliverables to support regulatory filing, product launch, and post market surveillance.
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Preferred: Certification by American Society of Clinical Pathologists (ASCP) or National Credentialing Agency (NCA) or equivalent agency as a Medical Technologist, Clinical Laboratory Scientist, Medical Laboratory Technician, or specialty certification.
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medical coding denials jobs in Boston, MA
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