- HCA Healthcare (Savannah, GA)
- **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
- LifePoint Health (Denver, CO)
- …coding /auditing Pro-Fee experience required * Minimum 3 years experience in coding audit or quality review work required * CPMA certification within ... would be working in a team environment with guidance from the Quality Supervisor and Manager, Coding Quality . This position also works closely with the… more
- CODAMETRIX (Boston, MA)
- …and back to clinical care. Overview Reporting to the Sr. Manager, Medical Coding & Audit , the Coding Quality Program Manager, will be a key member of the ... background in surgery and endoscopy, billing, and auditing to review , analyze, and enhance coding processes, both... related questions to drive world-class coding quality and consistency. + Present audit results… more
- Elevance Health (Norfolk, VA)
- …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 (St. Louis, MO)
- …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
- City of New York (New York, NY)
- …THE PRINCIPAL ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE. The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with ... Administrative Associate, who will function as a Senior Case Reviewer who will: - Conduct legally mandated case reviews...(Reynolds, Lovely H., MKB, Dajour, Davila, Brown, etc). Convert audit findings into reports that is presented to Family… more
- Magellan Health Services (Albuquerque, NM)
- …other clinical staff. + Provides training, interpretation and support for QI Clinical Reviewer staff. + Audits and validates internal audit results and/or ... record documentation. + Conducts ongoing activities which monitor established quality of care standards in the participating provider network...a team member. Knowledge of ICD and DSM IV coding or most current edition. Ability to analyze specific… more
- City of New York (New York, NY)
- …all statutory, regulatory and contractual standards. Within AO, is the Office of Quality Assurance & Fiscal Integrity conducts complex internal audits and quality ... identify areas of programmatic deficiencies. Within that area is the Process Evaluation Review Team (PERT). The unit analyzes error trends and determines the need… more
- CODAMETRIX (Boston, MA)
- …+ Leverage CodaMetrix coding standards to drive world-class coding quality and consistency. + Present audit results to customer stakeholders and ... clinical care. Overview Reporting to the Senior Manager, Medical Coding & Audit , as a Medical Coder...team responsible for ensuring that CodaMetrix meets-and exceeds-our customers' coding quality expectations. You will leverage your… more
- City of New York (New York, NY)
- …IN THE PRINCIPLE ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE. The Office of Quality Assurance & Fiscal Integrity ensures the integrity, efficiency, and regulatory ... legal and federal, state and city regulatory requirements. The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with… more
- Houston Methodist (Houston, TX)
- …specific practices. Serves a subject matter expert. + Effectively communicates audit results to faculty and staff. ** QUALITY /SAFETY ESSENTIAL FUNCTIONS** ... At Houston Methodist, the Sr Compliance Coding Analyst position is responsible for supporting accurate billing and coding compliance with Medicare and… more
- R1 RCM (Salt Lake City, UT)
- …. **Here's what you will experience working as a** **(** **Inpatient Coding Quality Reviewer ** **):** + Review inpatient coded cases for coding ... analytics, AI, intelligent automation, and workflow orchestration. The **Inpatient Coding Quality Reviewer ** will be...+ Audit records as defined in the coding quality review plan. +… more
- The Cigna Group (Bloomfield, CT)
- …Cigna IFP Coding Guideline updates and policy determinations, as needed. The Quality Review and Audit Analyst position recognizes individuals experienced ... **_Primary Functions:_** The _Quality Review & Audit Analyst_ is responsible...with internal and external partners, as well as performing quality reviews of vendor partner coding output.… more
- The Cigna Group (Bloomfield, CT)
- The Quality Review and Audit Lead Analyst will be instrumental in serving as a key subject matter expert in HHS risk adjustment regulations and coding ... in risk validation accuracy, compliance and engagement. Works in conjunction with coding audit oversight & compliance, Global Data & Analytics, network… more
- Kaleida Health (Buffalo, NY)
- …and execute quality audits, perform data analysis, trending, presentation of audit / review findings, and identify opportunities and develop a training plan ... ** Coding Quality Coordinator** **Location:** Larkin Bldg...the audit analysis, trending, and presentation of audit / review findings, potential issues and identifies opportunities… more
- Independent Health (Buffalo, NY)
- …a culture that fosters growth, innovation and collaboration. **Overview** The HCC Coding Quality Analyst is responsible for delivering educational seminars and/ ... CRG coding that is needed. The HCC Coding Quality Analyst is also responsible for...and/or providers or office staff to address questions about coding and documentation; or provide feedback on audit… 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
- Independent Health (Buffalo, NY)
- …a clinical setting or utilizing a coding system (ICD-10 or PCS) required. Coding audit experience in an inpatient setting preferred. + Knowledge of ICD-10-CM ... knowledge and auditing skills evidenced by their ability to train others, to identify coding patterns and share knowledge and audit tips across the team. The… more