- Datavant (Santa Fe, NM)
- …coded in a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical ... We're Looking For:** As an HCC (Hierarchical Condition Category) Auditor you will review medical records that have been...a diagnosis level + Answer rebuttals entered on the auditor by coders and or auditors + Participate in… more
- Datavant (Denver, CO)
- …educational and life experiences to realize our bold vision for healthcare. As an Auditor , HCC Risk Adjustment Coder, you will review medical records ... using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical… more
- Sharp HealthCare (San Diego, CA)
- …experience working as a certified coder. + 2 years' experience working as an HCC risk adjustment coding auditor . + Experience with medical billing, medical ... Technician (RHIT) - The American Health Information Management Association (AHIMA); Certified Risk Adjustment Coder (CRC) - American Academy of Professional… more
- Molina Healthcare (Albuquerque, NM)
- …**Knowledge/Skills/Abilities** * Assist in the daily operations of all aspects of risk adjustment data validation related activities, including, but not limited ... file transmissions, and adherence to applicable timelines * Support all risk adjustment audit related projects to ensure goals, objectives, milestones and… more
- MedKoder (Mandeville, LA)
- …company offers services including inpatient and outpatient facility coding, medical risk adjustment management, DRG coding management, coding education, clinical ... work week that offers a flexible schedule Description: Physician Coding Auditor is responsible for reviewing and accurately coding all professional multi-specialty… more
- Amazon (Herndon, VA)
- …(AWS). We are looking for a motivated Health and Safety (H&S) Lead Auditor to drive safety compliance, continuous improvement, and operational excellence across our ... organizational H&S performance - Support the design and delivery of internal auditor training - Earn trust of operations partners through proactive and continuous… more
- Bristol Myers Squibb (Princeton, NJ)
- …in their personal lives. Read more: careers.bms.com/working-with-us . Position Summary The Senior Auditor in GIA will work in a team environment to plan and execute ... dynamic risk -based audits and identify value-added recommendations to strengthen Company...key third-party outsourcing arrangements. Throughout the audits, the Senior Auditor will have the opportunity to interact with senior… more
- AdventHealth (Tampa, FL)
- …Guidelines and approved coding policies and procedures. . Participates in the mortality/ risk adjustment reviews when assigned. . Assists with post-payment DRG ... Center. **The ro** **le you'll contribute:** The Inpatient Coding Quality Auditor , under general supervision of the Inpatient Operations Manager, is responsible… more
- Molina Healthcare (St. Petersburg, FL)
- …monitoring, and oversight of all chart collection for HEDIS, or HEDIS-like projects, Risk Adjustment , Risk Adjustment Data Validation, and ... that support business objectives. + HEDIS Operations experience. + Risk Adjustment and Data Validation experience. +...be preferred for specific roles) * Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you… more
- Aston Carter (Rosemont, IL)
- …involves working closely with audit team members, internal clients, and other risk management and compliance functions. The position requires occasional travel to ... + Applied knowledge of accounting concepts, audit methodologies, and risk -based auditing techniques. + Familiarity with The IIA's International Professional… more
- Humana (Phoenix, AZ)
- …analyze large data sets + Knowledge of healthcare compliance, mainly primary care and risk adjustment , pharmacy knowledge a plus + Certified Coder (CPC, CRC, ... to assess, investigate, audit and validate the mitigation of compliance risk across the organization. This team ensures that healthcare providers align… more
- Amazon (Arlington, VA)
- …shared responsibility model as they migrate to the cloud. Are you a Governance, Risk , and Compliance leader who can address the challenges of migrating systems and ... cloud? Are you skilled at helping executives address their enterprise risk management requirements using highly scalable computing architectures? The AWS Security… more
- AIG (Atlanta, GA)
- At AIG, we are reimagining the way we help customers to manage risk . Join us as a Senior Underwriting Assistant to play your part in that transformation. It's an ... a Team Manager, Underwriting Support. This role assists the underwriters by screening risk offerings and with pre- and post-binding processes. The role also performs… more
- AIG (Scottsdale, AZ)
- …Multinational Clients. We are reimagining how we help customers to manage risk , transforming our operating model and reshaping our role responsibilities and career ... of the unit's field operations. This role assists the underwriters by screening risk offerings and with pre and post-binding processes. The role also performs… more
- Commonwealth of Pennsylvania (PA)
- …and organize all accounting files for review by the county's independent auditor . Your role will also involve providing technical assistance to service providers ... to post accounting entries to general ledger accounts. Prepares and posts adjustment transactions to correct or close accounts. Monitors, reconciles, and corrects… more
- SSM Health (MO)
- …scoring. + Collaborates with others regardingclinical documentation improvement (CDI) and risk adjustment (mortality) findings. + Maintains knowledge of Centers ... Performs as a vital member of the interdisciplinary care team member, an auditor , and an educator ensuring medical records are complete and clinical documentation… more
- Bristol Myers Squibb (New Brunswick, NJ)
- …and implementing a strategic global audit program to proactively identify risk areas while aligning with company objectives and regulatory requirements. They ... the optimal audit strategy in accordance with company objectives to proactively identify risk areas. + Lead, mentor, and develop a team of GMP/GDP auditors,… more
- RELX INC (Atlanta, GA)
- …of our GRC team? About the role: We are seeking an experienced Governance, Risk , and Compliance (GRC) Analyst to lead the development and implementation of our ... successful candidate will have a deep understanding of cybersecurity frameworks, risk management, and compliance standards, and will work collaboratively with… more
- NCH (Naples, FL)
- …well as applicable organizational policies and procedures. * Experience in MS-DRG and APR-DRGs, risk adjustment , HACs and PSIs, O/E mortality, and LOS. * Working ... assure documentation is clinically appropriate, accurately reflects the severity of illness and risk of mortality for the patient and is reflective of current CMS or… more
- Actalent (St. Louis, MO)
- …fostering a culture of continuous improvement and quality excellence. + Perform risk assessments and implement risk mitigation strategies related to product ... Skills & Qualifications + Certified Quality Engineer (CQE) or Certified Quality Auditor certification preferred. + Knowledge of FDA, EMA, ICH guidelines, and cGMP… more
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