- Upward Projects Holdings (Nashville, TN)
- …cost analysis. Enter, audit , and manage invoices, credits, and proper G/L coding . Partner with the GM on P&L review , cost communication, and coaching ... TO BE SUCCESSFUL YOU MUST Ensure excellence in food quality , portioning, speed, and waste control. Lead daily Taste...Manage relationships with food and beverage vendors to ensure quality , pricing, and service standards. Monitor supply needs and… more
- HCA Healthcare (Nashville, TN)
- **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
- Intermountain Health (Nashville, TN)
- …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
- HCA Healthcare (Nashville, TN)
- …is recognized. Submit your application for the opportunity below:Clinical Denials Coding Review SpecialistParallon. **Benefits** Parallon, offers a total rewards ... 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
- HCA Healthcare (Nashville, TN)
- …and you have the opportunity to make a difference. We are looking for a dedicated Inpatient Coding Audit Manager like you to be a part of our team. Job Summary ... Improvement (CDI) audits, and special project reviews. The IP Coding Audit Manager position will work on...fieldwork; and proposing modifications to current procedures to improve audit effectiveness and efficiency. + Performs quality … more
- HCA Healthcare (Nashville, TN)
- …the monthly random, focus, prebill review , and Ad Hoc quality review process + Submits and reviews coding appeals as appropriate What qualifications you ... with vendor management including monitoring processes and services for improvement, coding quality , trending/analyzing data, creating and presenting education,… more
- Datavant (Nashville, TN)
- …provide superior quality by performing audits pertaining to risk adjustment coding efforts. The individual will be responsible for daily operations pertaining to ... Management to implement benchmarks, establish acceptable thresholds, and effective quality assurance programs. You will: + Maintain a ...assurance program + Play a key role in ensuring coding compliance and accuracy + Monitor the performance of… more
- Datavant (Nashville, TN)
- …+ Provide monthly performance data to clients (eg, volume metrics, six-month trends, quality audit scores, and productivity levels). + Include action plans for ... educational and life experiences to realize our bold vision for healthcare. The ** Coding Operations Manager** is essential to the Provider HIM Coding division.… more
- Elevance Health (Nashville, TN)
- …letters. + Maintains accuracy and quality standards as established by audit management. + Identifies potential documentation and coding errors by recognizing ... the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. **How...clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding… more
- HCA Healthcare (Nashville, TN)
- …technologies, including, but not limited to NLP technologies including computer assisted coding , to further improve processes ( quality and efficiency) leading to ... portal, Health Information Exchange, Enterprise Information Management, Information Governance, HIM Coding Prebill Account Review Tool, etc.). + Assist in… more
- Datavant (Nashville, TN)
- …KPIs such as suspecting accuracy, chart throughput, RAF impact, data latency, coding quality metrics, and client engagement. **Cross-Functional Collaboration** + ... the development of robust, scalable, and actionable analytics that improve coding outcomes, measure product impact, and support value-based client delivery across… more
- Intermountain Health (Nashville, TN)
- …and payor guidelines, and ensures consistent and compliant application with charge/ coding capture, charge editing, and audit and reimbursement practices. ... within Intermountain's policies and procedures. Scope 1.Analyze data, develop reports, review trends, and recommend enhancements as defined by the RI leadership… more
- Sumitomo Pharma (Nashville, TN)
- …Characteristics (SmPC), and Canadian Product Monograph (PM) + Ensures timely and quality review and assessment of ICSRs, including seriousness, expectedness, ... safety narratives, adverse event coding , concomitant medication coding , and causality statements....study team meetings and governance committees. + Performs aggregate review of post-marketing safety data in support of safety… more
- Prime Therapeutics (Nashville, TN)
- …in accordance with procedures or to present to management to recommend for audit or investigation. Serves as a corporate resource on fraud, waste and abuse ... data to find suspicious patterns and outliers using knowledge of healthcare coding conventions, fraud schemes, and general areas of vulnerability. + Contact… more
- Cardinal Health (Nashville, TN)
- …patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to ... interaction using the appropriate database for the inquiry + Self- audit intake activities to ensure accuracy and efficiency for...1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience + 1-2 years experience with Prior… more
- HCA Healthcare (Nashville, TN)
- …for our team to ensure that we continue to provide all patients with high quality , efficient care. Did you get into our industry for these reasons? We are an ... Operating system management includes installation, patching, customization, and security audit compliance. Utilize project planning and coordination skills and… more
