- Elevance Health (Houston, TX)
- …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
- Kaiser Permanente (Pasadena, CA)
- …Qualifications Four (4) years hospital coding experience. Four (4) years coding audit experience. COMPANY: KAISER TITLE: Compliance Consultant IV - Risk ... six (6) years experience in health care compliance, health care operations ( quality , risk, etc.), audit , finance, regulatory or public policy development,… more
- UnitedHealth Group (Tampa, FL)
- …business hours. Primary Responsibilities: Maintains and demonstrates expert knowledge of coding , coding operations, coding review of all coding staff ... Leadership with oversight of processes and initiatives designed to continuously improve coding quality and/or efficiency. Maintains expert knowledge of coding… more
- BJC HealthCare (St. Louis, MO)
- …Provides guidance and serves as mentor to fellow coordinators related to the audit process, coding , billing and compliance; identifies and notifies management ... City/State: Saint Louis, Missouri Categories: Legal and Audit Job Status: Full-Time Req ID : 99993...Our providers are nationally recognized for excellent patient satisfaction, quality health care, and improving the health and well-being… more
- Datavant (Boise, ID)
- …you will be instrumental in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding ... coding references for accurate DRG and APC assignment. Review non-CC/MCC records to assess proper coding ...the appropriate manager. Prepare the final reports for the coding audit and actively participates in the… more
- Capital One (New York, NY)
- … Audit function is a dedicated group of professionals focused on delivering top- quality assurance services to the organization's Audit Committee. Audit ... projects to management via written reports and oral presentations. Review and provide feedback on audit workpapers...multiple priorities and tasks across the team to deliver quality results. Coordinate with others and proactively take on… more
- Datavant (Raleigh, NC)
- …you will be instrumental in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding ... (at least 30 hours/week). MUST have 3-5+ years of audit experience at an Academic/Trauma Level 1 facility. Experience...tool preferred. What You Will Do: Performs Inpatient Facility coding audits according to scope of work, for the… more
- Capital One (Chicago, IL)
- … Audit function is a dedicated group of professionals focused on delivering top- quality assurance services to the organization's Audit Committee. Audit ... a collaborative, agile environment to deliver value-added opinions and recommendations. Audit 's vision to provide high value, independent, proactive insights, to… more
- Coinbase (Carson City, NV)
- …alignment. Attendance is expected and fully supported. Coinbase is looking for an Internal Audit Senior, IT to join the Internal Audit team focusing primarily on ... US (Remote) and will be reporting to an Internal Audit IT Senior Manager. The individual will be responsible...to maximize meetings utility, testing efficiencies and internal controls review coverage across the organization. Serve as a value-add… more
- Datavant (Trenton, NJ)
- …you will be instrumental in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding ... Seeking a profee auditor proficient in multi-specialty including procedure and E/M coding in multiple settings What You Will Do: Performs Professional Fee … more
- Grant Thornton (Atlanta, GA)
- …and help you achieve more, confidently. Your day-to-day may include: Review operational, financial, and administrative processes to assess risk, internal control, ... include but are not limited to co-sourced and outsourced internal audit , internal control assessments, enterprise risk management program assessments, tests of… more
- UnitedHealth Group (Tampa, FL)
- … quality audit practices to ensure UHC SIU's Medical Record Review Team is adhering to proper coding /clinical guidelines and ensuring clinical ... care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the...with providers to explain review / medical record review findings and the application of coding /clinical… more
- Elevance Health (Grand Prairie, TX)
- …or insurance sector), including a minimum of 1 year related experience in a quality audit capacity; or any combination of education and experience, which would ... Performance Quality Analyst II Location: This role requires associates...implementation audits of providers, claims processing and payment, benefit coding , member and provider inquiries, enrollment & billing transactions… more
- UnitedHealth Group (Minnetonka, MN)
- …criteria documentation requirements used to successfully substantiate code assignments Perform clinical coding review to ensure accuracy of medical coding ... reimbursement trends, and client processes and requirements Maintain and manage daily case review assignments, with a high emphasis on quality Provide clinical… more
- Elevance Health (Washington, DC)
- …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
- Cedars-Sinai (Los Angeles, CA)
- …innovation. Req ID : 13346 Working Title : Claims Edit Coder Department : CSRC Coding Audit Business Entity : Cedars-Sinai Medical Center Job Category : Patient ... claim edit fall outs. The position entails conducting modifier review and assignment, handling complex coding edits...coding system (HCPCS) while adhering to productivity and quality standards for the area(s) of assignment or specialty… more
- Houston Methodist (Katy, TX)
- …and commercial payer audits. Oversee case intake, documentation collection, quality review , and timely submission. Track and analyze audit trends, denials, ... and appeal outcomes to identify risks and recommend improvements. Compliance & Quality Assurance Ensure all audit activity complies with CMS, commercial payer,… more
- Trinity Health (Livonia, MI)
- …Managed Care department staffs. Audits Charge Master for each department including review of appropriate coding , departmental and pricing concerns; and ensuring ... basic knowledge of TH policies, practices & processes to ensure quality , confidentiality, & safety are prioritized. Demonstrates knowledge of departmental processes… more
- PwC IT Services Co. (Houston, TX)
- …Requirements Analysis, C#.NET, C++ Programming Language, Client Management, Code Review , Coding Standards, Communication, Computer Engineering, Computer Science, ... needs of your teams and clients, and to deliver quality . Embracing increased ambiguity, you are comfortable when the...technical standards (eg refer to specific PwC tax and audit guidance), the Firm's code of conduct, and independence… more
- ADM (Kennesaw, GA)
- …entities. Prepare payroll and lease accounting journal entries with correct GL coding . Maintain Spreadsheet Server financial reports. Review and approve journal ... 103260BR Job Title: Accounting Manager-Kennesaw, GA Department/Function: Finance, Accounting, Audit Job Description: Accounting Manager - Kennesaw, GA ADM Deerland… more
