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Highmark Health
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Charleston, West Virginia
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Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology ... in various coding applications and electronic medical record systems to support departmental goals
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Highmark Health
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Charleston, West Virginia
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This job performs thorough medical record review to abstract medical and demographic data, interpret ... medical information, physician treatment plans, course, and outcome to determine appropriate ICD-10 CM/CPT
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Highmark Health
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Charleston, West Virginia
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Credentialing Specialist (CPCS) OR Certified Professional Medical Services Management (CPMSM ... of the Medical Staff and Allied Health Professional Staff of AHN entities. Responsible for the
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Highmark Health
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Charleston, West Virginia
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Certified Medical Coder or related
SKILLS
Demonstrated ability to solve issues that are ... a pre-payment and retrospective claims review basis. Review process includes a review of medical
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Highmark Health
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Charleston, West Virginia
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Company :
Endorsed
Job Description :
GENERAL OVERVIEW
The Medical Director will provide qualified medical direction and consultation for care delivery and complex case
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Highmark Health
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Parkersburg, West Virginia
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, pharmacy benefit design, pharmacy policy, medical drug policy, therapeutic alternatives, medication ... reviews, adherence to pharmacy and medical drug policy, and adherence to the Organization’s formulary
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Highmark Health
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Charleston, West Virginia
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chronic medical conditions offering integrated and comprehensive interventions. The incumbent uses ... primary integrated case manager for members with mental health/substance use and co-morbid chronic medical
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Highmark Health
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Charleston, West Virginia
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assures that members with complex medical and/or psychosocial needs have access to high quality, cost ... of Medical Terminology and Medical Diagnostic Categories/Disease States
Educate members in order
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Highmark Health
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Charleston, West Virginia
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to medical, pharmacy, clinically based, and wellness and prevention offerings, and non-medical based
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Highmark Health
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Charleston, West Virginia
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electronically and using Medical Policy criteria sets to evaluate the medical necessity and appropriateness of ...
ESSENTIAL RESPONSIBILITIES
Conduct electronic review of escalated cases against medical policy
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Highmark Health
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Charleston, West Virginia
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course within twelve months in either Life Office Management Association (LOMA) Certified Employee
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Highmark Health
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Charleston, West Virginia
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electronically and using Medical Policy criteria sets to evaluate the medical necessity and appropriateness of ... .
ESSENTIAL RESPONSIBILITIES
Conduct electronic review of escalated cases against medical policy
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Highmark Health
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Charleston, West Virginia
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Company :
Highmark Inc.
Job Description :
JOB SUMMARY
The Medical Economics Consultant is responsible for the development, coordination and management of medical economics
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Highmark Health
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Charleston, West Virginia
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appropriate.
Adherence to Allegheny Health Network policies and procedures regarding medical record
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Highmark Health
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Charleston, West Virginia
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accessing virtual/physical medical and behavioral care in tight collaboration with our Experience, Strategy
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