- HCA Healthcare (Brownsville, TX)
- **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 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
- LifePoint Health (Denver, CO)
- …coding /auditing Pro-Fee experience required * Minimum 3 years experience in coding audit or quality review work required * CPMA certification within ... would be working in a team environment with guidance from the Quality Supervisor and Manager, Coding Quality . This position also works closely with the… 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 (Grand Prairie, TX)
- …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 (St. Petersburg, FL)
- …role with production and quality metric goals. What you'll do: + Review provider disputes for DRG Coding and Clinical Validation (MS and APR), ... findings. + Research and analysis of content for bill review . + Use of strong coding and...review content, including but not limited to DRG Reviewer Rationales, DRG Clinical Validation Policies, CCR Review… more
- City of New York (New York, NY)
- …with all statutory, regulatory, and contractual standards. The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with ... Administrative Associate, who will function as a Senior Case Reviewer : - Conduct legally mandated case reviews to comply...(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
- 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
- CODAMETRIX (Boston, MA)
- …+ Leverage CodaMetrix coding standards to drive world-class coding quality and consistency. + Present audit results to customer stakeholders and ... clinical care. Overview Reporting to the Senior Manager, Medical Coding & Audit , as a Medical Coder...team responsible for ensuring that CodaMetrix meets-and exceeds-our customers' coding quality expectations. You will leverage your… more
- Intermountain Health (Phoenix, AZ)
- …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
- Houston Methodist (Houston, TX)
- …specific practices. Serves a subject matter expert. + Effectively communicates audit results to faculty and staff. ** QUALITY /SAFETY ESSENTIAL FUNCTIONS** ... At Houston Methodist, the Sr Compliance Coding Analyst position is responsible for supporting accurate billing and coding compliance with Medicare and… more
- R1 RCM (Denver, CO)
- …expect as out Coding Quality Associate:** + Audits records as defined in the coding quality review plan. + Review cases flagged by the coding ... sophisticated analytics, AI, intelligent automation, and workflow orchestration. The **Inpatient Coding Quality Associate** will be responsible for reviewing… more
- HCA Healthcare (Brentwood, TN)
- …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
- The Cigna Group (Bloomfield, CT)
- …liaises with Matrix Partners, as required, to develop and promote shared goals. The Quality Review and Audit Senior Analyst position recognizes experience in ... (RADV), Risk Adjustment operations, Risk Adjustment medical record and diagnosis coding excellence, implementation of Quality Improvement processes, and the… more
- The Cigna Group (Bloomfield, CT)
- … Coding Guideline updates and policy determinations, as needed. Education & Experience: The Quality Review & Audit Analyst will have a high school diploma ... Job Summary: The Risk Adjustment Quality & Review Analyst in IFP brings medical coding ...(RA) programs, including the Risk Adjustment Data Validation (RADV) audit and the Supplement Diagnosis submission program. Inclusive of… more
- HCA Healthcare (Richmond, VA)
- …is recognized. Submit your application for the opportunity below: Clinical Denials Coding Review Specialist Parallon. **Benefits** Parallon, offers a total ... vary by location._** We are seeking a Clinical Denials Coding Review Specialist for our team to...met in compliance with departmental policies and procedures + Review Medicare Recovery Audit Contractor (RAC) recoupment… more
- Banner Health (OH)
- …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
- Independent Health (Buffalo, NY)
- …a clinical setting or utilizing a coding system (ICD-10 or PCS) required. Coding audit experience in an inpatient setting preferred. + Knowledge of ICD-10-CM ... knowledge and auditing skills evidenced by their ability to train others, to identify coding patterns and share knowledge and audit tips across the team. The… more
- Atlantic Health System (Morristown, NJ)
- Responsible for coding quality audits of all records (outpatient, inpatient, procedures, testing) to assure appropriateness and accurate code assignments in ... coding trends found during chart reviews, third party audit findings, and annual coding updates. +...rejections from recurring. + Meets with the providers to review the audit findings and to recommend… more