- Lyric (Newtown Square, PA)
- …editing solution, as a payment, reimbursement or medical policy analyst, medical claims processor, chart auditor /reviewer, or claims edit/denial ... insurance payers, while managing a team of high performing Clinical Managers and Medical Content Analysts. In this intricate role, the Senior Clinical Manager will… more
- FlexStaff (Chappaqua, NY)
- **Req Number** 172252 Surgical Anesthesia Compliance AuditorCompliance Auditor Surgical Anesthesia Compliance Auditor - Hybrid position- Chappaqua, NY- ... a meaningful impact? FlexStaff is seeking a detail-oriented and experienced Compliance Auditor to join our client's dynamic team! This hybrid position offers the… more
- Sharp HealthCare (San Diego, CA)
- …*This is a remote position* **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) compliance ... Functions** + Coding ComplianceCompliance Coding and Billing AuditsThe Compliance Coding Auditor has the primary responsibility of performing all audits and … more
- Humana (Washington, DC)
- …and independent determination of the appropriate courses of action. The Nurse Auditor 2 validates and interprets medical record documentation to ensure ... part of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record… more
- Albany Medical Center (Albany, NY)
- …to include system development and maintenance documentation. + Perform timely medical record chart reviews (which could include prospective, concurrent ... Salary Range: $60,367.47 - $90,551.20 This position has remote opportunity Professional Coding Auditor will apply an advanced professional coding skill set to act as… more
- Insight Global (Plano, TX)
- …DRG Auditors to join a remote healthcare organization. The DRG Revenue Integrity Auditor will perform Diagnostic Related Group (DRG) validation and quality audits on ... based on the candidates years of experience. Key Responsibilities: Conduct thorough chart reviews to validate that assigned codes accurately reflect the patient's… more
- Elevance Health (Hanover, MD)
- …you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines and objectivity in the performance ... formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **DRG CODING AUDITOR ** is responsible for… more
- Elevance Health (Las Vegas, NV)
- …you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance ... is granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure… more
- Insight Global (South Jordan, UT)
- …assignment accuracy. Below are the key responsibilities for this role: Integrates medical chart coding principles, clinical guidelines, and objectivity in the ... Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100%...payment systems. This position is responsible for auditing inpatient medical records and generating high-quality recoverable claims for the… more
- Providence (WA)
- **Description** The Revenue Cycle Auditor is responsible for providing patient focused, standardized, compliant revenue cycle support that will assist Providence St ... Joseph Health in meeting financial objectives. - Conduct audits (individual chart /bill audits, focus audits, compliance audits, payer defense audits, patient… more
- AdventHealth (Orlando, FL)
- …the service line level. Reporting findings to leaders on a regular basis. + Conducts chart reviews in the Electronic Medical Record (EMR) as directed to assure ... The Surgical and Procedural Services Safety and Regulatory Compliance Auditor evaluates the surgical and procedural environment, policies, and procedures… more
- Dartmouth Health (Lebanon, NH)
- …competency in working with regulatory/clinical issues and/or professional or facility chart abstraction, CPT and ICD-9 coding and clinical documentation education ... and reimbursement guidelines required. * Knowledge of professional or facility chart abstraction, CPT and ICD-9 coding and clinical documentation highly desired.… more
- Atlantic Health System (Morristown, NJ)
- …reported + Audits codes and professional fee services performed by providers from medical records according to ICD-10, CPT, HCPCS, and CMS guidelines + Responsible ... coding such as appropriate documentation, accurate coding, coding trends found during chart reviews, third party audit findings, and annual coding updates. +… more
- Williams Adley (Washington, DC)
- …mentoring, professional membership/subscription dues, and professional development opportunities, you can chart a unique and fulfilling career path on your terms. ... and that of your family. Our health insurance offerings include comprehensive medical , dental, and vision plans, as well as firm-paid Basic Life/AD&D insurance.… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- …CPC-Payer, Certified Interventional Radiology Cardiovascular Coder (CIRCC) and Certified Professional Medical Auditor (CPMA) + Experience: A minimum of 1 ... IS NOT A REMOTE POSITION We are hiring a Medical Records Clerk/Coder to assign procedure, and diagnosis codes...that Outpatient charts are received daily. + Runs missing chart report and notifies appropriate personnel. + Follows through… more
- Baystate Health (Springfield, MA)
- …to transfer and discharge. Explains and obtains signatures for Medicare forms. Organizes chart for Medical Records, faxes or copies records as needed. Sends ... rotating holidays required **LOCATION** : + Baystate Main Campus, Medical /Neuro ICU Unit + Springfield, MA **THE ADVANTAGES OF...C Word, OA Gold, SMS, CIS, Premise, BMD, PCM Auditor , People Soft and Staples and Kronos access if… more
- St. Luke's University Health Network (Allentown, PA)
- …or coding determination made by the government or commercial payors, or their auditor representative. + Facilitate clinical chart reviews to assist with ... health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure codes… more
- Molina Healthcare (Omaha, NE)
- …with ad hoc projects. **Job Duties** + Performs the role of the HEDIS medical record review overreader/ auditor which includes ongoing review of records reviewed ... conducts oversight and audits of the data collected and abstracted from medical records for HEDIS projects, HEDIS like projects and supplemental data collection.… more
- NCH (Naples, FL)
- …is comprised of two hospitals, an alliance of 700+ physicians, and medical facilities in dozens of locations throughout Southwest Florida that offer nationally ... to: Provide higher acuity care and Centers of Excellence; Offer Graduate Medical Education and fellowships; Have endowed chairs; Conduct research and participate in… more
- Molina Healthcare (IA)
- …implementation of HEDIS activities, including the identification, collection and abstraction of medical records and other data in support of annual HEDIS project ... management and ongoing review of medical records submitted by providers. + Implements Molina Healthcare...departments (eg, Risk Adjustment) to ensure prospective and/or retrospective chart reviews and completed timely and accurately. + Effectively… more
