- Sharp HealthCare (San Diego, CA)
- …and employer business practices. **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) ... compliance audit program. The position provides oversight and maintenance of...+ Coding ComplianceCompliance Coding and Billing AuditsThe Compliance Coding Auditor has the primary responsibility of performing all audits… more
- UL, LLC (Allentown, PA)
- …one or more scope specific professional credential(s), such as: GFSI recognized auditor credential; CQA, RABQSA, IRCA, RAC , Pharmaceutical GMP Professional ... Lead Auditor - GMP Quality Audits will perform high...report in accordance with UL, industry scheme, and client audit protocols on facilities working and/or operational conditions as… more
- Highmark Health (Harrisburg, PA)
- …entities in response to external coding audits conducted by the Medicare Administrative Contractor , the RAC , MIC, ZPIC, etc. Determine appeal action, prepare ... OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and… more
- Amergis (San Antonio, TX)
- …$40 / Hour Inpatient Denials Auditor must have experience with the following: - RAC / RAM Denials - Claim Adjustment Denials - PSI / HAC Reviews - Stroke ... Accounts - Creating Appeal Letters - Focused DRG Reviews for missed CC or MCC Comfortable with Re-Coding accounts and providing feedback to original coders EPIC & Optum CAC experience (REQUIRED) AHIMA REQUIRED Benefits At Amergis, we firmly believe that our… more
- St. Luke's University Health Network (Allentown, PA)
- …and procedure code assignment and MS-DRG/APR-DRG accuracy based on denials or audit findings from government and commercial payers. Meet or exceed established ... the physician advisor in review of patient medical records identified by RAC /MIC/QIO and other governmental or commercial payor auditors in retrospective reviews for… more
- UNC Health Care (Morrisville, NC)
- …standards such as CPT coding guidelines and CMS policies. Assists in preparing annual audit and work plan. Performs work outlined in work plan. Obtains and analyzes ... Assists in development of new policies and procedures and audit tools. Performs E/M and Procedural coding audits. Analyzes...and ensures correct coding and billing compliance. Assists with RAC audits and review of other outside requests as… more
- Wolters Kluwer (Chicago, IL)
- …and recommending comprehensive upgrades to prevent future issues . Lead Auditor Certified, preferred . Regulatory Affairs Certification ( RAC ), preferred. ... Kluwer. Important responsibilities include cross-functional correspondence, quality management reviews, audit support, change planning, and corrective and preventative action… more
- The US Pharmacopeial Convention (USP) (Rockville, MD)
- …to cGMP requirements and proficiency with regulation and guideline interpretation, audit procedures, proper documentation, and quality assurance. * Experience with ... Certification from the American Society for Quality (ASQ) as a Certified Quality Auditor (CQA) and/or from the Regulatory Affairs Professional Society (RAPS) as a… more