- 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)
- …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
- 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
- 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)
- …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
- 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. ... policies and procedures. Revenue Integrity Analyst II 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
- PwC IT Services Co. (Nashville, TN)
- …to anticipate the needs of your teams and clients, and to deliver quality . Embracing increased ambiguity, you are comfortable when the path forward isnt clear, ... professional and technical standards (eg refer to specific PwC tax and audit guidance), the Firm's code of conduct, and independence requirements. This position… 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
- Humana (Nashville, TN)
- …of compliance policies and procedures related to risk adjustments activities, including coding accuracy, encounter data submission, and chart review practices. + ... + Building working relationships with internal stakeholders and supporting external audit preparation efforts. + Demonstrating an understanding of departmental and… 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 ... any payer issues to the appropriate team + Must self- audit activities to ensure accuracy and efficiency for the...the Affordable Care Act preferred + Knowledge of ICD9/ICD10 coding is preferred + Critical and creative thinking, preferred… more