- Geisinger (Danville, PA)
- … requirements. Determines the adequacy of medical record documentation, coding , and billing, using established compliance auditing and research guidelines ... Job Summary The Compliance Auditor position is responsible for... compliance audits to determine the adequacy of medical record documentation, billing, and coding , utilizing… more
- Humana (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of ... codes (eg, ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Guthrie (Sayre, PA)
- Option to be Hybrid/Remote. Summary: A senior level compliance coding auditor conducting assessments in accordance with The Guthrie Clinic's policies and ... procedures and accepted guidelines for medical coding . Works closely with the Compliance Officer and Compliance coding Audit Coordinator to perform… more
- Highmark Health (Harrisburg, PA)
- … as set forth by the American Health Information Management Association and Corporate Compliance Coding Guidelines. Assures compliance with the coding ... (Outpatient): Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or… more
- CVS Health (Harrisburg, PA)
- …+ Thorough knowledge of coding guidelines and regulations to meet compliance requirements, such as establishing medical necessity. + In depth knowledge ... process and Hierarchical Condition Categories CRC (HCC)CPMA (Certified Professional Medical Auditor ), CDEO (Certified Documentation Expert Outpatient) or… more
- WelbeHealth (Harrisburg, PA)
- …is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring ... reviews + Oversee audits and participate in provider education programs to ensure compliance with CMS risk adjustments diagnosis coding guidelines + Work closely… more
- CVS Health (Harrisburg, PA)
- …+ Sound knowledge of coding guidelines and regulations to meet compliance requirements, such as establishing medical necessity. + Identify clinically active ... and directives. + Conducts self- process audits to ensure compliance with internal policies and procedures as well as...Minimum of 1 year recent and related experience in medical record documentation review, diagnosis coding , and/or… more
- UPMC (Pittsburgh, PA)
- …technical school diploma is preferred. + 3 or more years of experience in medical coding , billing, auditing and compliance . + Extensive knowledge of ... **Join UPMC Corporate Compliance as an Intermediate Compliance Auditor !** Are you passionate about ensuring...Certified Evaluation & Management Coder (CEMC) + Certified Professional Medical Auditor (CPMA) + Certified Professional Coder… more
- UPMC (Pittsburgh, PA)
- …degree or comparable technical school diploma is preferred. + 1 year of experience in medical coding , auditing, billing and compliance . + Knowledge of CMS ... **Join UPMC Corporate Finance as a Compliance Auditor , Associate!** Are you detail-oriented and passionate about ensuring compliance in healthcare? **UPMC… more
- St. Luke's University Health Network (Allentown, PA)
- …Services Auditor performs audits as part of the Documentation and Coding Compliance Program for professional services billed by providers employed with ... meet with providers to perform education for the professional service documentation and coding audits of both office and in-patient medical records. + Maintain… more
- St. Luke's University Health Network (Allentown, PA)
- … coding audit activities. The incumbent will also review and validate coded medical records of the Professional Coding (PC) staff to determine data quality ... Professional Auditor (CPMA); Certified Professional Coder (CPC); Certified); Certified Coding Specialist (CCS); In-depth knowledge of ICD CM, ICD PCS and… more
- St. Luke's University Health Network (Allentown, PA)
- …for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure ... Coding and CDMP Managers for education of the medical staff, clinical documentation professionals and the coding...Administrative Law Judge (ALJ) hearings and/or formal meetings with auditor or payor representatives in defense of coding… more
- Datavant (Harrisburg, PA)
- …you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding ... future of healthcare from your own workspace! Preferred: Inpatient auditor with 3-5 years of experience at a Trauma...SMART software experience preferred. **You Will:** + Conduct inpatient coding audits on medical records, utilizing ICD-10-CM,… more
- Datavant (Harrisburg, PA)
- …you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding ... healthcare from your own workspace! Preferred: An experienced FT auditor (at least 30 hours/week). MUST have 3-5+ years...preferred. **What You Will Do:** + Performs Inpatient Facility coding audits according to scope of work, for the… more