- Humana (Boise, ID)
- …is a full-time, remote/work-from-home position. **Description** The Inpatient Medical Coding Auditor extracts clinical information from medical records and ... is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for...modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum… more
- Veterans Affairs, Veterans Health Administration (Boise, ID)
- …medications, procedures as well as the principles and practices of health services and the organizational structure to ensure proper code selection. Reviews assigned ... that categorizes all VA patients into specific classes representing their clinical conditions and resource needs. Monitors ever-changing regulatory and policy… more
- Datavant (Boise, ID)
- …for healthcare. **What We're Looking For:** As an HCC (Hierarchical Condition Category) Auditor you will review medical records that have been coded in a ... purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity...a diagnosis level + Answer rebuttals entered on the auditor by coders and or auditors + Participate in… more
- Highmark Health (Boise, ID)
- …and disease processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and assistance from management, ... Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician coding and/or… more
- Humana (Boise, ID)
- …business partners to uphold ethical standards and mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance, by ensuring ... data requires an in-depth evaluation of variable factors. As the Senior Clinical Compliance Professional, you will develop and/or evaluate compliance policies and… more
- Molina Healthcare (Boise, ID)
- …other departments within the organization + Supports provision of high-quality clinical care and services by facilitating/building strategic relationships with ... Member & Community Interventions oversees and implements new and existing clinical quality member intervention initiatives including all lines of business (Medicare,… more