- BrightSpring Health Services (Louisville, KY)
- Our Company BrightSpring Health Services Overview The Clinical Coding and Audit Specialist monitors, responds and performs the clinical coding and ... minimize lost revenue. Conducts analysis on timely submission of coding reviews and supports branches to prevent edit lock...branch staff to gather required information and submits timely response to ADR requests + Monitors OASIS timing and… more
- The Cigna Group (Philadelphia, PA)
- …research, analysis and response to inquiries from all internal and external audit departments regarding compliance, coding and inappropriate coding + ... Professional Coder (CPC) Certified Risk Adjustment Coder (CRC) Certified Coding Specialist for Providers (CCS-P) Certified ...real time data + Assists with research, analysis and response to inquiries regarding compliance, coding , and… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …healthcare? Bring your true colors to blue. What We Need The Senior Audit Specialist role will review paid claims for coding accuracy in accordance to claims ... guidelines, BCBSMA Medical and Payment Policies, contract interpretations and established audit protocols. The role involves detailed claims analysis of complex… more
- Highmark Health (Jefferson City, MO)
- …**GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data ... (Inpatient or Outpatient): Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) + AAPC Credentials (Outpatient): Certified… more
- LifePoint Health (Brentwood, TN)
- …Health Information Administrator (RHIA),**Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), ... within coding area of department. . Assesses coding accuracy and competency through review and audit...pending accounts with timely follow up. Daily review and response to Business Office holds. . Prioritizes coding… more
- PeaceHealth (Vancouver, WA)
- **Description** PeaceHealth is seeking a full time Healthcare Compliance Specialist - Organizational Integrity. This remote role requires the incumbent to reside in ... the Healthcare Compliance Program, including responding to inquiries and assisting with response tracking. + Acts as a liaison for the Healthcare Compliance… more
- Burrell Behavioral Health (Springfield, MO)
- …Description: Essential Job Functions: + Conducts investigations of billing, coding and documentation concerns identified through the Compliance Disclosure Program. ... Analyze and investigate payor refund requests and provide recommendations on response (eg submit appeal, issue refund). + Documents investigation process,… more
- New York State Civil Service (Schenectady, NY)
- …Developmental Disabilities, Office for Title Mental Hygiene Program Evaluation Specialist 3 Occupational Category Health Care, Human/Social Services Salary Grade ... Minimum Qualifications MINIMUM QUALIFICATIONS:* Currently in Mental Hygiene Program Evaluation Specialist 3, Grade 23 titleor* Eligible for 70.1 or 52.6 transfer… more
- Do it Best Corp. (Fort Wayne, IN)
- LTL Transportation Specialist Level: Pay Class 4 Division: Logistics Reports to: Inbound Operations Manager Travel: Minimal, at the needs of the business This ... our vendors related to LTL invoicing via our Transportation Management Freight Audit and Pay, and claims processing via EZClaim software. Accountable for review,… more
- Trinity Health (Howell, MI)
- …payment arrangements. Obtains medical authorization or referral forms, if appropriate. Audit authorizations for accuracy and determine if delay/deny policy needs to ... information, insurance eligibility, coordination of benefits, authorization requirements) in response to patient inquiries and issues. Works to resolves these… more
- The Cigna Group (Memphis, TN)
- …research, analysis and response to inquiries from all internal and external audit departments regarding compliance, coding , and inappropriate coding . + ... and efficient. + Review and act on any assigned audit educational opportunities timely and provide primary care or...(CPC) + Certified Risk Adjustment Coder (CRC) + Certified Coding Specialist for Providers (CCS-P) + Registered… more
- The Cigna Group (Chattanooga, TN)
- …research, analysis, and response to inquiries from all internal and external audit departments regarding compliance, coding , and inappropriate coding . + ... and efficient. + Review and act on any assigned audit educational opportunities timely and provide primary care or...(CPC) + Certified Risk Adjustment Coder (CRC) + Certified Coding Specialist for Providers (CCS-P) + Registered… more
- The Cigna Group (UT)
- …research, analysis, and response to inquiries from all internal and external audit departments regarding compliance, coding , and inappropriate coding . + ... and efficient. + Review and act on any assigned audit educational opportunities timely and provide primary care or...(CPC) + Certified Risk Adjustment Coder (CRC) + Certified Coding Specialist for Providers (CCS-P) + Registered… more
- Penn Medicine (Philadelphia, PA)
- …prepared materials. The CA I also provides guidance to the Compliance Specialist . Accountabilities + Performs systematic review of outpatient and inpatient records ... the medical staff. + Performs focused medical reviews in response to internal/external allegations or as triggered by any...and Associate Director. + Prepares materials, appropriate research and audit in order to conduct a meaningful New Provider… more
- Ventura County (Ventura, CA)
- …by the American Health Information Management Association (AHIMA): + Certified Coding Specialist (CCS) + Registered Health Information Administrator (RHIA) ... Certificates and Licenses section of your application. + Certified Coding Specialist (CCS) + Registered Health Information...coding experience is required for this position. Your response to this supplemental question must be thorough and… more
- AdventHealth (Maitland, FL)
- …develop and lead a broad and diversified range of risk adjustment coding services for the AdventHealth Population Health Ri Clinical Documentation Integrity Program. ... the overall structure and operations to support programs in Risk Adjustment coding , CDI review, working on Electronic Medical Record tools, Communication protocols,… more
- LA Care Health Plan (Los Angeles, CA)
- …each file. Inform nurses of a new case received from Grievance and Appeals Specialist .; submit all Grievances and Appeals response letters to Grievances ... Summary The Authorization Technician II supports the Utilization Management (UM) Specialist by handling all administrative and technical functions of the… more
- STG International (Washoe County, NV)
- …facility surveys (inspections) made by authorized government agencies as requested. + Audit nursing documentation in the clinical record for appropriate and relevant ... + Attend and contribute in facility "triple check" process for reviewing coding for accuracy. + Perform administrative duties such as completing medical forms,… more
- Sharp HealthCare (San Diego, CA)
- …products are accurate and patient friendly. Performs random review of charge audit findings to assure prompt response to repeat/recurring charge ... Trainer/Educator, Payment Processing staff, Shared Service Analyst, Uncompensated Care Specialist , and Hospital Auditors. The Manager is responsible for coordinating… more
- Boston College (Chestnut Hill, MA)
- …of various security monitoring systems. Day-to-day tasks include cyber incident response , evaluation and implementation of requests for firewall changes, monitoring ... of various security products and audit logs, and providing technical guidance regarding these products....to a SoC analyst or a policy & governance specialist . Title and salary commensurate with relevant experience based… more