- 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
- Elevance Health (Nashville, TN)
- …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
- 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
- Intermountain Health (Nashville, TN)
- …and payor guidelines, and ensures consistent and compliant application with charge/ coding capture, charge editing, and audit and reimbursement practices. ... policies and procedures. **Revenue Integrity Analyst II** 1.Analyze data, develop reports, review trends, and recommend enhancements as defined by the RI leadership… 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
- 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
- HCA Healthcare (Nashville, TN)
- …learned and best practice opportunities. The Data Analyst will collect, review and enter data into computer systems/applications or tracking databases according ... in support of ad-hoc and standing requests for monitoring and benchmarking of coding vendor performance + Determines and devises mechanisms for data collection and… 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 ... for every interaction using the appropriate database for the inquiry + Must self- audit intake activities to ensure accuracy and efficiency for the program + Make… more