- Aequor (Thousand Oaks, CA)
- …reports. Ensure vendor compliance with approved processes and training requirements. Oversee case quality of US ICSRs (CT and PM) including analysis and reporting of ... trends in quality measures. Point of accountability for managing one or...assigned business partners. Case processing point of contact for audit related activities related to case processing. Accountable for… more
- HCA Healthcare (Orange Park, FL)
- **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
- AdventHealth (Altamonte Springs, FL)
- …AHA Coding Clinic, CMS guidelines, NCCI guidance, etc. + Provides outcomes of coding quality audit reviews with leadership + Maintains current knowledge ... as supporting on-going quality assurance needs for coding staff. They will review medical records...and/or outpatient coding policies, procedures, and established audit schedule; translates quality auditing results into… more
- AdventHealth (Daytona Beach, FL)
- …AHA Coding Clinic, CMS guidelines, NCCI guidance, etc. Provides outcomes of coding quality audit reviews with leadership Maintains current knowledge of ... as supporting on-going quality assurance needs for coding staff. They will review medical records...and/or outpatient coding policies, procedures, and established audit schedule; translates quality auditing results into… more
- Elevance Health (Chicago, IL)
- …based DRG Coding / Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad knowledge of medical claims ... medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review...information to make audit determinations and generate audit findings letters. + Maintains accuracy and quality… more
- Zelis (FL)
- …interests that shape who you are. Position Overview The Inpatient DRG Reviewer will be primarily responsible for conducting post-service, pre-payment and post pay ... comprehensive inpatient DRG reviews based on industry standard inpatient coding guidelines and rules, evidence based clinical criteria plan, and policy exclusions.… more
- City of New York (New York, NY)
- …THE PRINCIPAL ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE. The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with ... Administrative Associate, who will function as a Senior Case Reviewer who will: - Conduct legally mandated case reviews...(Reynolds, Lovely H., MKB, Dajour, Davila, Brown, etc). Convert audit findings into reports that is presented to Family… more
- City of New York (New York, NY)
- …all statutory, regulatory and contractual standards. Within AO, is the Office of Quality Assurance & Fiscal Integrity conducts complex internal audits and quality ... identify areas of programmatic deficiencies. Within that area is the Process Evaluation Review Team (PERT). The unit analyzes error trends and determines the need… more
- Zelis (NJ)
- …responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG Quality Assurance reviews in an effort to increase the savings achieved ... as they compare with medical records utilizing ICD-10 Official Coding Guidelines, AHA Coding Clinic evidence based...What you'll do: + Perform comprehensive inpatient DRG validation Quality Assurance reviews to determine accuracy of the DRG… more
- City of New York (New York, NY)
- …IN THE PRINCIPLE ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE. The Office of Quality Assurance & Fiscal Integrity ensures the integrity, efficiency, and regulatory ... legal and federal, state and city regulatory requirements. The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with… more
- Redeemer Health Home Care & Hospice (Huntingdon Valley, PA)
- …journey. We invite you to apply today. SUMMARY OF JOB The Certified Risk Adjustment Coding / Audit Reviewer is a physician facing position and must have ... of diagnosis coding on risk adjustment payment models. Understand the audit process for risk adjustment models. Ability to identify and communicate documentation… more
- St. Luke's University Health Network (Allentown, PA)
- …be responsible for performing internal, concurrent, prospective and retrospective coding audit activities. The incumbent will also review and validate coded ... medical records of the Professional Coding (PC) staff to determine data quality ...one-on-one education sessions for PCs needing focused attention on audit findings. In addition, works in conjunction with network… more
- Carle Health (Champaign, IL)
- …Carle physician groups. Oversee all aspects of inpatient, outpatient and professional coding operations, clinical documentation, coding audit and education, ... state and payer regulations and driving initiatives to improved coding quality and efficiency. The Director will...organizational skills + Knowledge of all major aspects of coding and audit and documentation integrity functions… more
- HCA Healthcare (Dublin, GA)
- …Do you want to join an organization that invests in you as a Pro Fee Coding Quality Review Educator? At Parallon, you come first. HCA Healthcare has ... difference. We are looking for a dedicated Pro Fee Coding Quality Review Educator like... coding strongly preferred. + Inpatient/outpatient professional fee coding experience required. + Previous audit experience… more
- Virtua Health (Mount Laurel, NJ)
- …depending on meetings with clinicians. Job Summary: Responsible for professional fee (pro-fee) coding quality and audits, education and training, etc. for CPT, ... coding team (modules, scenarios, tip sheets, etc.). External Coding Audit Response: Conducts Trains new coders... samples, communicating results to clinicians and providing annual coding education. Performing chart audits to review … more
- Deschutes County (Bend, OR)
- Quality Analyst, Health Services (Medical Coding ) (Part-time) Print (https://www.governmentjobs.com/careers/deschutes/jobs/newprint/5075987) Apply Quality ... for billed services. Core duties include auditing documentation for compliant coding and other requirements and delivering audit results, and developing… more
- CVS Health (IN)
- …all with heart, each and every day. **Position Summary** Responsible for performing quality inter-rater review audits of medical records coded by internal team ... mentor to provide education to internal staff based on audit findings; provides general education on ICD codes as...years recent and related experience in medical record documentation review , diagnosis coding , and/or auditing. + Experience… more
- Highmark Health (Pittsburgh, PA)
- …to CMS for reimbursement.Oversee operations to track and validate multi-pass quality review of validation leading up to external audit of Highmark Inc. ... strategy to achieve continuous improvements as it relates to Quality and Coding for the Highmark Health...coding results: Lead team of coder/ clinicians to review member medical records to validate 100% of new… more
- Hartford HealthCare (Farmington, CT)
- …official coding guidelines This position reports to Manager Hospital HIM Coding Quality and Education *Education:* Associates Degree or equivalent experience ... state and federal laws, regulations and policy. * Presents audit reports, results and action plans to coding...Coding and Billing* **Organization:** **Hartford HealthCare Corp.* **Title:** * Coding Quality & Edu Spec 1 /… more
- Premier Health (Dayton, OH)
- …duties; greeting patients, scanning, faxing, copying, sorting mail, etc. Support co-workers in quality audit , coding and billing and comply with ICD10/CPT ... Work cooperatively with other personnel to assist with billing, coding , compliance, and quality requirements for the... coding & chart review to assist with accurate documentation and timely release… more
