- CVS Health (Charleston, WV)
- …systems and on daily operations and programs + Responsible to support targeted quality audit projects. Report results and make recommendations eg, training ... service to our internal and external customers. **Position Summary** + Performs routine quality audits for network operations and claim testing for PPO … more
- Cardinal Health (Charleston, WV)
- …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 ... and continuous improvement. Accurately score interactions to gauge employee's quality performance based on organizational and departmental policies and requirements.… more
- Highmark Health (Charleston, WV)
- …retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, ... **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all...in the audits compliant with regulatory requirements. Provides written audit guidance. Participates with management in the assessment of… more
- Cardinal Health (Charleston, WV)
- …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 ... point of contact handling inbound calls, with ability to determine needs and provide one call resolution + Process enrollments via inbound fax, phone, and… more
- Humana (Charleston, WV)
- …with upstream business partners such as Claims, Clinical Guidance, and the Provider Network to identify opportunities and drives initiatives that will ... midst of a people, process and technology transformation that will improve quality , timeliness and the overall experience for our associates, members and providers.… more
- Cardinal Health (Charleston, WV)
- …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 ... may receive general guidance on new assignments + May provide general guidance or technical assistance to less experienced...inquiry + Make all outbound calls to patient and/or provider to discuss any missing information and/or benefit related… more
- Cardinal Health (Charleston, WV)
- …experience, preferred. Diploma or degree in relevant field desirable. + 3+ years' call quality audit experience strongly preferred. + 3+ years' experience in a ... remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer...that can be improved or celebrated. + Analyze and provide weekly & monthly trend analysis to leadership. +… more
- Datavant (Charleston, WV)
- …presenting to leadership, clients, and your Team via Video or in person. + Solution provider and forward thinking + Detail and quality oriented as it relates to ... is powered by the largest, most diverse health data network in the US, enabling data to be secure,...with leadership on issues, opportunities, or challenges. + Lead Audit Team which receives requests from Payors + Review… more
- Nelnet (Charleston, WV)
- …with the industry standards for compliance and information security issues to provide our customers with world class information security & compliance services. ... with the industry standards for compliance and information security issues to provide our customers with world class information security & compliance services. The… more
- Datavant (Charleston, WV)
- …life experiences to realize our bold vision for healthcare. The individual will provide superior quality by performing audits pertaining to risk adjustment ... is powered by the largest, most diverse health data network in the US, enabling data to be secure,...pertaining to auditing functions as assigned. The individual will provide superior customer experience by educating internally and externally… more
- Datavant (Charleston, WV)
- …the right format. Our platform is powered by the largest, most diverse health data network in the US, enabling data to be secure, accessible and usable to inform ... content to re-educate team on coding error trends + Train and provide ongoing teaching/technical assistance to internal staff/external partners + Oversee the… more