- Aptyx (Taunton, MA)
- …performance. Accounts Payable & Accounts Receivable Support Process AP/AR including invoice review , coding , and reconciliation. Review purchase orders, ... leadership teams. Compliance, Audits & Documentation Support internal and external audit requests and provide required documentation. Maintain accurate and organized… 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 ... vary by location._** Come join our team as a 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 (Chicago, IL)
- …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 (Norfolk, 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
- Dana-Farber Cancer Institute (Brookline, MA)
- …adherence to government, payer, and institutional billing guidelines as well as national coding guidelines. The Senior Reviewer will assist in the development ... Work Plan, CMS transmittals, CPT/ICD updates) and internal operational risks, recommending audit priorities and monitoring strategies. + Review government and… 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 DRG review s . + Use of strong coding...review content, including but not limited to DRG Reviewer Rationales, DRG Clinical Validation Policies and Dispute Rationales… 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
- 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 ... Principal Administrative Associate, to function as a Senior Case Reviewer who will: - Conduct legally mandated case reviews...(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
- 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
- Community Health Systems (Springdale, AR)
- As a coding consultant , you'll join a team and be a part of a culture that's dedicated to providing top quality care to our patients. Our full-time employees ... and student loan assistance for eligible roles. **Job Summary** The coding consultant ensures precise code assignment for inpatient, outpatient, and emergency… more
- University of Miami (Medley, FL)
- …compliant coding on all Mortality cases prior to billing. The Inpatient Coding Review Specialist also performs quality reviews that specifically focus ... -Health Information Management Departmenthas an exciting opportunity for a full-time Inpatient Coding Review Specialist (H) to work remotely. The Inpatient … more
- Carle Health (Champaign, IL)
- …Carle coding team members, and external coders to assure a high level of coding quality and accuracy for Carle. The manager organizes and coordinates the ... coding audit teams to achieve goals and reviews and implements policies to assure compliance with recommended coding quality levels. As part of the Health… more
- HCA Healthcare (Ocala, FL)
- **Description** **Introduction** Do you have the career opportunities as a Clinical Denial Coding Review Specialist you want with your current employer? We have ... Do you want to work as a Clinical Denial Coding Review Specialist where your passion for...met in compliance with departmental policies and procedures + Review Medicare Recovery Audit Contractor (RAC) recoupment… more
- Providence (CA)
- …the best people, we must empower them._** **Providence Health Plan is calling a Coding Quality Auditor, HEDIS who will:** + Be responsible for conducting ... + **This posting is for multiple openings of a Coding Quality Auditor, HEDIS** + **This position...in a medical record. + 2 years - HEDIS, Quality management/ quality improvement/utilization review auditing… 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
- Hartford HealthCare (Farmington, CT)
- … & Education Specialist develops and implements an effective and comprehensive audit & education program for coding consistent with regulatory, contractual, ... management, procedure, risk adjustment program requirements and ICD 10 coding guidelines. Reporting to Manager of Audit ...training for providers and staff to ensure updates and quality assurance on coding . 3. Creates and… more
- Albany Medical Center (Albany, NY)
- …with others as needed to ensure comprehensive and timely completion of professional coding processes. Audit CPT and ICD-10 diagnosis coding applied ... in professional fee coding - required Essential Duties and Responsibilities + Review , analyze, and validate CPT and ICD-10 diagnosis codes and charges applied by… more
- Cedars-Sinai (Los Angeles, CA)
- …education materials acting as subject matter expert. + Tracks, records, and maintains audit / review activity in software or excel spreadsheets. + Provides regular ... Award 19 years in a row for providing the highest- quality medical care in Los Angeles. We also were...records, and charges to ensure compliance with applicable documentation, coding , and billing requirements. Works closely with providers and… more
- CVS Health (Springfield, IL)
- …+ Minimum of 1 year recent and related experience in medical record documentation review , diagnosis coding , and/or auditing. + AA/AS or equivalent experience. + ... all with heart, each and every day. **Position Summary** Responsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and… more
