- 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
- Elevance Health (Nashville, TN)
- …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
- 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
- Banner Health (TN)
- …coding background to a team that values growth and development! This is a Quality position, not a day-to-day coding production role but does require coding ... Coding experience.** This position is task-production-oriented ensuring quality in the Inpatient Facility Coding department....audit of clinical documentation to ensure that clinical coding is accurate for proper reimbursement and that … 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
- HCA Healthcare (Brentwood, TN)
- …meaningful as we do. We want you to apply! **Job Summary and Qualifications** The Coding Auditor is responsible for performing quality reviews and audits of the ... that we continue to provide all patients with high quality , efficient care. Did you get into our industry...opportunity compelling, we encourage you to apply for our Coding Auditor opening. We promptly review all… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Documentation Review Specialist conducts quality audits and reviews of medical records to ensure accurate coding and billing practices ... and National and Local Coverage Determinations (NCDs and LCDs). + Participates in quality assurance by submitting bi-annual samples of audit work and maintaining… more
- Covenant Health Inc. (Knoxville, TN)
- …conducted by Revenue Integrity Department Auditors and Appeal Coordinators. Oversees audit and denials management workflow including quality and reporting. ... entities to lead and conduct revenue cycle and compliance audit projects as they relate to charging, coding...manager. + Works with contract management personnel in the review of contracts and other reimbursement or payment arrangements… 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
- Datavant (Nashville, TN)
- …participant materials + Provide support to client relations for trainings needed for client audit findings + Research and analysis of coding error trends What ... Adjustment Trainer to help us uplevel our Risk Adjustment Coding Department through improving overall coding accuracy...learning to the work environment through various methods + Review client level audits and advise training content to… more
- The Cigna Group (Nashville, TN)
- ** Quality Assurance Claims Systems Auditor, Senior Analyst** Are you passionate about driving growth and improving lives? EviCore, a division of The Cigna Group is ... seeking a Quality Assurance Claims Systems Auditor, Senior Analyst. In this...Systems Auditor, Senior Analyst. In this critical role, you'll audit all contract details loaded into our claims systems,… 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. ... Intermountain's policies and procedures. **Essential Functions** 1.Analyze data, develop reports, review trends, and recommend enhancements as defined by the RI… 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
- Humana (Nashville, TN)
- …+ Research and analyze compliance information necessary to support internal and external audit activity. + Act as "Go To" person for resolution of issues relating ... attention to detail and investigative skills + Ability to partner with peers to review needs and possible solutions + Must be passionate about contributing to an… 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