- HCA Healthcare (Falls Church, VA)
- **Description** **Introduction** Do you want to join an organization that invests in you as a Coding Quality Audit Reviewer ? At Parallon, you come first. ... make a difference. We are looking for a dedicated Coding Quality Audit Reviewer...result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to… more
- Datavant (Washington, DC)
- …provide superior quality by performing audits pertaining to risk adjustment coding efforts. The individual will be responsible for daily operations pertaining to ... Management to implement benchmarks, establish acceptable thresholds, and effective quality assurance programs. You will: + Maintain a ...assurance program + Play a key role in ensuring coding compliance and accuracy + Monitor the performance of… more
- Datavant (Washington, DC)
- …+ Provide monthly performance data to clients (eg, volume metrics, six-month trends, quality audit scores, and productivity levels). + Include action plans for ... educational and life experiences to realize our bold vision for healthcare. The ** Coding Operations Manager** is essential to the Provider HIM Coding division.… more
- Capital One (Mclean, VA)
- … Audit function is a dedicated group of professionals focused on delivering top- quality assurance services to the organization's Audit Committee. Audit ... a collaborative, agile environment to deliver value-added opinions and recommendations. Audit 's vision to provide high value, independent, proactive insights, to… more
- Capital One (Mclean, VA)
- … Audit function is a dedicated group of professionals focused on delivering top- quality assurance services to the organization's Audit Committee. Audit ... Senior Audit Manager - Cyber Technical, Technology Audit...and organized information, tailoring communication style to audience. Effectively review and compile relevant, material findings and recommendations into… more
- Elevance Health (Washington, DC)
- …letters. + Maintains accuracy and quality standards as established by audit management. + Identifies potential documentation and coding errors by recognizing ... the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. **How...clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding… more
- Intermountain Health (Washington, DC)
- …and payor guidelines, and ensures consistent and compliant application with charge/ coding capture, charge editing, and audit and reimbursement practices. ... policies and procedures. **Revenue Integrity Analyst II** 1.Analyze data, develop reports, review trends, and recommend enhancements as defined by the RI leadership… more
- Datavant (Washington, DC)
- …KPIs such as suspecting accuracy, chart throughput, RAF impact, data latency, coding quality metrics, and client engagement. **Cross-Functional Collaboration** + ... the development of robust, scalable, and actionable analytics that improve coding outcomes, measure product impact, and support value-based client delivery across… more
- Sumitomo Pharma (Washington, DC)
- …Characteristics (SmPC), and Canadian Product Monograph (PM) + Ensures timely and quality review and assessment of ICSRs, including seriousness, expectedness, ... safety narratives, adverse event coding , concomitant medication coding , and causality statements....study team meetings and governance committees. + Performs aggregate review of post-marketing safety data in support of safety… more
- CVS Health (Washington, DC)
- …Revenue Integrity initiatives. + Responsible for leading the reconciliation of data ( coding review results and medical record images) from different sources, ... support of auditing activities related to vendor reconciliation of coding results and medical record images as well as...to meeting business needs. + Tightly managing vendor data quality and timeliness; ensure data is ingested into CREW… more
- Prime Therapeutics (Washington, DC)
- …in accordance with procedures or to present to management to recommend for audit or investigation. Serves as a corporate resource on fraud, waste and abuse ... data to find suspicious patterns and outliers using knowledge of healthcare coding conventions, fraud schemes, and general areas of vulnerability. + Contact… more
- Hilton (Washington, DC)
- …Ledger Coordinate and verify receiving tickets, purchase orders and invoices for proper coding and approval signature Review all final statements for accuracy, ... away\. The ideal candidate will possess similar experience in Finance or Night audit /Front Desk\. We are looking for a team\-player, with excellent computer skills… more
- Epsilon, Inc (Falls Church, VA)
- …with industry regulations. + Work with DevOps teams to implement secure coding practices and foster secure CI/CD development pipelines. + Support the evaluation ... + Document all security-related activities and maintain detailed records for audit and compliance purposes. + Enhance Threat Intelligence Capabilities - Research… more
- Humana (Washington, DC)
- …+ Research and analyze compliance information necessary to support internal and external audit activity. + Act as "Go To" person for resolution of issues relating ... attention to detail and investigative skills + Ability to partner with peers to review needs and possible solutions + Must be passionate about contributing to an… more
- Cardinal Health (Washington, DC)
- …patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to ... for every interaction using the appropriate database for the inquiry + Must self- audit intake activities to ensure accuracy and efficiency for the program + Make… more