- HCA Healthcare (Nashville, TN)
- …growth, we encourage you to apply for our Coding Quality Audit Reviewer opening. We promptly review all applications. Highly qualified candidates ... vary by location._** Come join our team as a 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 (Chicago, IL)
- …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 (Ashburn, VA)
- …Group (DRG) Coding /Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad knowledge of medical ... 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
- Dana-Farber Cancer Institute (Brookline, MA)
- …adherence to government, payer, and institutional billing guidelines as well as national coding guidelines. The Senior Reviewer will assist in the development ... Work Plan, CMS transmittals, CPT/ICD updates) and internal operational risks, recommending audit priorities and monitoring strategies. + Review government and… more
- Zelis (St. Petersburg, FL)
- …role with production and quality metric goals. What you'll do: + Review provider disputes for DRG Coding and Clinical Validation (MS and APR) ... findings. + Research and analysis of content for DRG review s . + Use of strong coding...review content, including but not limited to DRG Reviewer Rationales, DRG Clinical Validation Policies and Dispute Rationales… more
- Zelis (FL)
- …interests that shape who you are. Position Overview The Inpatient DRG Reviewer will be primarily responsible for conducting post-service, pre-payment and post pay ... comprehensive inpatient DRG reviews based on industry standard inpatient coding guidelines and rules, evidence based clinical criteria plan, and policy exclusions.… more
- City of New York (New York, NY)
- …with all statutory, regulatory and contractual standards. The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with ... Principal Administrative Associate, to 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
- St. Luke's University Health Network (Allentown, PA)
- …be responsible for performing internal, concurrent, prospective and retrospective coding audit activities. The incumbent will also review and validate coded ... medical records of the Professional Coding (PC) staff to determine data quality ...one-on-one education sessions for PCs needing focused attention on audit findings. In addition, works in conjunction with network… more
- Community Health Systems (Springdale, AR)
- As a coding consultant , you'll join a team and be a part of a culture that's dedicated to providing top quality care to our patients. Our full-time employees ... and student loan assistance for eligible roles. **Job Summary** The coding consultant ensures precise code assignment for inpatient, outpatient, and emergency… more
- Carle Health (Champaign, IL)
- …Carle coding team members, and external coders to assure a high level of coding quality and accuracy for Carle. The manager organizes and coordinates the ... coding audit teams to achieve goals and reviews and implements policies to assure compliance with recommended coding quality levels. As part of the Health… more
- St. Luke's University Health Network (Allentown, PA)
- …clinical documentation improvement issues and through excellent communication with physicians, coding and CDMP leadership, Quality Dept. coordinators, and other ... and/or formal meetings with auditor or payor representatives in defense of coding appeals, as needed. + Maintain necessary audit /appeal activity documents… more
- Hartford HealthCare (Newington, CT)
- …official coding guidelines This position reports to Manager Hospital HIM Coding Quality and Education *Education:* Associates Degree or equivalent experience ... state and federal laws, regulations and policy. * Presents audit reports, results and action plans to coding...Coding and Billing* **Organization:** **Hartford HealthCare Corp.* **Title:** * Coding Quality & Edu Spec 1 /… more
- University of Miami (Medley, FL)
- …compliant coding on all Mortality cases prior to billing. The Inpatient Coding Review Specialist also performs quality reviews that specifically focus ... -Health Information Management Departmenthas an exciting opportunity for a full-time Inpatient Coding Review Specialist (H) to work remotely. The Inpatient … more
- Cleveland Clinic (Cleveland, OH)
- …one of the most respected healthcare organizations in the world. As a Coding Quality Education Coordinator, you will provide one-on-one and classroom-based ... clinical documentation and coding education to medical staff, Advanced Practice Providers and...and operational systems and processes relative to reimbursement and quality statistics through chart review and other… more
- HCA Healthcare (Ocala, FL)
- **Description** **Introduction** Do you have the career opportunities as a Clinical Denial Coding Review Specialist you want with your current employer? We have ... Do you want to work as a Clinical Denial Coding Review Specialist where your passion for...met in compliance with departmental policies and procedures + Review Medicare Recovery Audit Contractor (RAC) recoupment… more
- Providence (CA)
- …the best people, we must empower them._** **Providence Health Plan is calling a Coding Quality Auditor, HEDIS who will:** + Be responsible for conducting ... + **This posting is for multiple openings of a Coding Quality Auditor, HEDIS** + **This position...in a medical record. + 2 years - HEDIS, Quality management/ quality improvement/utilization review auditing… more
- Atlantic Health System (Morristown, NJ)
- Responsible for coding quality audits of all records (outpatient, inpatient, procedures, testing) to assure appropriateness and accurate code assignments in ... coding trends found during chart reviews, third party audit findings, and annual coding updates. +...rejections from recurring. + Meets with the providers to review the audit findings and to recommend… more
- Cedars-Sinai (Los Angeles, CA)
- …education materials acting as subject matter expert. + Tracks, records, and maintains audit / review activity in software or excel spreadsheets. + Provides regular ... Award 19 years in a row for providing the highest- quality medical care in Los Angeles. We also were...records, and charges to ensure compliance with applicable documentation, coding , and billing requirements. Works closely with providers and… more
- Albany Medical Center (Albany, NY)
- …with others as needed to ensure comprehensive and timely completion of professional coding processes. Audit CPT and ICD-10 diagnosis coding applied ... in professional fee coding - required Essential Duties and Responsibilities + Review , analyze, and validate CPT and ICD-10 diagnosis codes and charges applied by… more
- Fairview Health Services (St. Paul, MN)
- …Liaison to join our team! Coding Documentation Liaison. Documentation Liaison of Coding Quality and Support is a highly motivated professional who can work ... roles and influence the need for correct coding and compliance. Coding Documentation Liaisons perform retrospective and prospective Quality Assurance Checks… more