- 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
- Intermountain Health (Washington, DC)
- …creates appeals for all payer and regulatory denials and downgrades and provides in-depth coding review , audit findings, and appeal strategies. + Develops ... **Job Description:** The HIM Coding Audit Training Analyst Coordinator provides...coding patterns and trends. + Participates in hospital quality improvement initiatives to assure accurate reimbursement + Participates… 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
- 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
- Intermountain Health (Washington, DC)
- …and payor guidelines, and ensures consistent and compliant application with charge/ coding capture, charge editing, and audit and reimbursement practices. ... within Intermountain's policies and procedures. Scope 1.Analyze data, develop reports, review trends, and recommend enhancements as defined by the RI leadership… 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
- Office of Administration (District Of Columbia, DC)
- …Language (SQL), Business Objects, and/or Jira; 2) Performing HR information systems review through developing quality control criteria, error control criteria, ... for various reports requests from various components of EOP, Audit related requests, and to leadership to make informed...a relational database management system 5 (RDBMS); 4) Using coding and computer programming knowledge in SQL, and other… 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
- 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 ... interaction using the appropriate database for the inquiry + Self- audit intake activities to ensure accuracy and efficiency for...1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience + 1-2 years experience with Prior… more