- 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
- Elevance Health (Norfolk, VA)
- …based DRG Coding / Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad, deep and niche knowledge of ... all lines of business, and its clients. Specializes in review of DRG coding via medical record...or appeals may only be reviewed by other DRG Coding Audit Principals (or Executives). **How you… more
- Elevance Health (Richmond, VA)
- …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
- Intermountain Health (Richmond, VA)
- …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
- Banner Health (VA)
- …teams with different focuses (Facility vs Profee)._ In this **Inpatient Facility-based HIMS Coding Quality Associate** position, you bring your **5 years of ... team that values growth and development! This is a Quality position, not a day-to-day coding production...audit of clinical documentation to ensure that clinical coding is accurate for proper reimbursement and that … more
- Datavant (Richmond, VA)
- …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 (Richmond, VA)
- …+ 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 ... 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
- 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
- Elevance Health (Richmond, VA)
- …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 (Richmond, VA)
- …participant materials + Provide support to client relations for trainings needed for client audit findings + Research and analysis of coding error trends What ... Adjustment Trainer to help us uplevel our Risk Adjustment Coding Department through improving overall coding accuracy...learning to the work environment through various methods + Review client level audits and advise training content to… more
- Intermountain Health (Richmond, VA)
- …and payor guidelines, and ensures consistent and compliant application with charge/ coding capture, charge editing, and audit and reimbursement practices. ... Intermountain's policies and procedures. **Essential Functions** 1.Analyze data, develop reports, review trends, and recommend enhancements as defined by the RI… more
- Datavant (Richmond, VA)
- …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 (Richmond, VA)
- …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
- Mill Creek Residential (Falls Church, VA)
- …and reporting issues. + Review and approve all hourly time sheets. + Audit of material and equipment purchase tickets for correct coding as prepared by ... + Risk analysis and mitigation + Special issues - Review the performance of all assigned construction associates including...administration, and profitability + Material and equipment procurement + Quality of work + Quality of relationships… more
- DR Horton, Inc. (Midlothian, VA)
- …Profit Analyses and review gross profit margins for each sales contract * Review SG&A expenses and provide coding . Assist in SG&A forecast preparation * ... York Stock Exchange. It is engaged in the construction and sale of high quality homes designed principally for the entry-level and first time move-up markets. The… more
- Prime Therapeutics (Richmond, VA)
- …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 (Richmond, VA)
- …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
- 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 (Richmond, VA)
- …+ 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