- Hartford HealthCare (Hartford, CT)
- …invite you to become part of Connecticut's most comprehensive healthcare network. The Revenue Compliance Auditor contributes to the success of the Office of ... clinical documentation, coding and billing audits as assigned or scheduled. The Revenue Compliance Auditor performs independent reviews to assess compliance … more
- Guthrie (Sayre, PA)
- Option to be Hybrid/Remote. Summary: A senior level compliance coding auditor conducting assessments in accordance with The Guthrie Clinic's policies and ... procedures and accepted guidelines for medical coding. Works closely with the Compliance Officer and Compliance coding Audit Coordinator to perform audits… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Clinical Revenue Auditor -CDM Patient Financial Services-Corporate-Full-Time-Days-Option to work remote or hybrid.** The Clinical Revenue ... Auditor for the Mount Sinai Health System (MSHS) and...a key role in ensuring the financial health and compliance of the organization and bridges the gap between… more
- Humana (Corpus Christi, TX)
- …1 consults and collaborates with clinicians to ensure high accountability of compliance and quality. The Quality Assurance, Clinical Professional 1 work assignments ... **Use your skills to make an impact** CMS regulations, OASIS accuracy, and Medicare Conditions of Participation demand meticulous documentation. A QA Auditor … more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- **42425BR** **Extended Job Title:** Medical Coding Auditor **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** Responsible for auditing ... medical records to ensure accurate coding and compliance with regulatory requirements. This role ensures continuous quality improvement in coding practices while… more
- Humana (Boise, ID)
- …caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns ... codes (eg, ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis… more
- MedKoder (Mandeville, LA)
- …services including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare , Medicaid, and third-party payer ... work week that offers a flexible schedule Description: Physician Coding Auditor is responsible for reviewing and accurately coding all professional multi-specialty… more
- CHS (Clearwater, FL)
- **Overview** ** ** **Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance ... claims and customer service calls to ensure validity, accuracy, and compliance with appropriate policies, procedures, and regulations + **Health, Dental, Vision, and… more
- AdventHealth (Altamonte Springs, FL)
- …to achieve industry best practice levels of performance. The Corporate Quality Auditor will adhere to AdventHealth Corporate Compliance standards, as well ... you will contribute:** The inpatient or outpatient coding team Corporate Quality Auditor (QA)/Educator supports the operations of the inpatient or outpatient coding… more
- LA Care Health Plan (Los Angeles, CA)
- …Plans Auditor III Claims Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... net required to achieve that purpose. Job Summary The Specialty Health Plans Auditor III Claims is responsible for all aspects of planning, execution, reporting and… more
- Marshfield Clinic (Marshfield, WI)
- …to support the most exciting missions in the world!** **Job Title:** Claims Auditor (Remote - WI or MN) **Cost Center:** 682891379 SHP-Claims **Scheduled Weekly ... (United States of America) **Job Description:** **JOB SUMMARY** The Claims Auditor is responsible for performing payment, procedural accuracy, turnaround time, … more
- Avera (Sioux Falls, SD)
- …(WPS), and CGS Administrators at the present time. + Assists Avera facilities through compliance focused Medicare reviews to resolve and minimize risks for a ... of information between medical record and billing departments. A successful Auditor assists in the organization and presentation of educational workshops and… more
- Nuvance Health (Danbury, CT)
- …State and Federal regulatory and reimbursement guidelines, maintains compliance while optimizing appropriate revenue opportunities 3.QA activities including ... performed by Outpatient Coding team for accuracy. 4.Work closely with the Compliance department on audits, reporting, complaint coding issues etc. 5.Research CMS and… more
- Baystate Health (Springfield, MA)
- …documentation for professional billing to ensure it meets the AMA and CMS ( Medicare ) guidelines for the services billed, reviewing and validating billed charges and ... interacts with employees at all levels. The incumbent has an understanding of compliance audit concepts. This includes but is not limited to relaying confidential… more
- UCLA Health (Los Angeles, CA)
- …next level. You can do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned to the ... auditor . You will review claims (paid, pending, and denied)...services, contract interpretation, Division of Financial Responsibility (DOFR), and application/ compliance with policies and procedures. You will: + Research… more
- Atlantic Health System (Morristown, NJ)
- …assure appropriateness and accurate code assignments in accordance with Center of Medicare and Medicaid (CMS) guidelines and provide ongoing feedback and analysis of ... + Audit charts for accurate and correct coding and compliance within documentation guidelines and AHS policies + Prepares...and billing department + Provides clarification on coding and compliance policies Required: * CPC Certification * Minimum 6… more
- CVS Health (IN)
- …CDQA) to ensure the ICD-10 codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... to appropriate departments and management. + Conducts process audits to ensure compliance with internal policies and procedures and existing CMS regulations. +… more
- Highmark Health (Nashville, TN)
- …with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts ... system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare… more
- Avera (Sioux Falls, SD)
- …patients. Work where you matter.** **A Brief Overview** The Senior Coding Auditor is responsible for auditing technical and professional services. The individual ... on education and/or improvement plans. Emergent reviews may be performed based on compliance and clinical need. This individual will be required to understand and… more
- Robert Half Accountemps (Cincinnati, OH)
- Description We are looking for a detail-oriented Medical Coding Auditor to join our team in Cincinnati, Ohio. In this Contract-to-Permanent position, you will play a ... critical role in ensuring the accuracy and compliance of outpatient medical coding processes. This role is ideal for professionals with a strong background in… more