- Capital One (Goochland County, VA)
- … Audit function is a dedicated group of professionals focused on delivering top- quality assurance services to the organization's Audit Committee. Audit ... Senior Tech Audit Manager - Global Payment Network Capital One's...the effectiveness of existing controls, identify and define issues, review and analyze evidence, and document client processes and… more
- Stanford Health Care (Palo Alto, CA)
- …and edit appeals for clarity and accuracy prior to submission to ensure high- quality presentation. + Audit Response: Ensuring the medical record documentation ... America) **This is a Stanford Health Care job.** **A Brief Overview** Clinical Government Audit Analyst and Appeal Specialist II plays a critical role in the Revenue… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …to ensure departmental KPIs and regulatory compliance are consistently met Implement Medical Review Prospective & Retrospective Quality Review of cases ... find better and more innovative ways to improve their quality of life. We're changing lives for a living....to make a difference? The Position The Director Medical Review oversees a team of Medical Reviewers responsible for… more
- Memorial Sloan-Kettering Cancer Center (New York, NY)
- …reflects severity of illness and risk of mortality + Perform record abstraction, coding , and data collection to support reimbursement, quality initiatives, and ... documentation reflects the highest standards of accuracy, integrity, and quality . We are anticipating openings for two roles on...hoc, and special project reviews requiring advanced CDI and coding knowledge + Audit medical records to… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …evolve, so does our challenge to find better and more innovative ways to improve their quality of life. We're changing lives for a living. Are you ready to make a ... Safety, with cross-functional working relationships within Intake and Triage, Medical Review , Submissions and Compliance, Global Safety, and centralized teams (eg,… more
- Jobleads-US (Chicago, IL)
- …charge capture for all procedures completed in the Bronchoscopy suite. This includes: Audit of CPT codes associated with each procedure Confirmation of supplies used ... Provides guidance regarding clinical documentation to optimize charges and RVUs Confirms coding accuracy based on clinical documentation and reviews common errors or… more
- Olympus Corporation of the Americas (Center Valley, PA)
- …standards, data review and query management, and is accountable for quality study dataset release and consistency for submission data. This role is responsible ... the Sr. Clinical Data Manager is accountable for driving timely and high- quality data management deliverables supporting the Olympus portfolio. The Sr. Clinical Data… more
- Oatey (Cleveland, OH)
- **Why Oatey?** Since 1916, Oatey has provided reliable, high- quality products for the residential and commercial plumbing industries, with a commitment to delivering ... quality , building trust and improving lives. Today, Oatey operates...expense vouchers and maintains accurate records and control reports. Review applicable accounting reports and accounts payable register to… more
- Alexandria Real Estate Equities, Inc (Pasadena, CA)
- …checking for accuracy of the dollar amount, verifying general ledger coding to invoice support, monitoring time-sensitive invoices, reviewing for completeness of ... fees and/or service interruptions. + Assist with the annual review of the vendor master file, including review...credit card transactions for payment and obtain general ledger coding as part of month-end accounting close. + Prepare… more
- HCA Healthcare (Overland Park, KS)
- **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...and global coding education based on the quality monitoring review findings and trends. **What… 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
- HCA Healthcare (Nashville, TN)
- …growth, we encourage you to apply for our Coding Quality Audit Reviewer opening. We promptly review all applications. Highly qualified candidates ... result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to... of patient data, to ensure minimal variation in coding practices and to improve the 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
- Elevance Health (Hanover, MD)
- …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
- 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
- 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
- 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
- Intermountain Health (Broomfield, CO)
- …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
- 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
