- Medical Mutual of Ohio (OH)
- …RN experience, DRG,_** **_and/or_** **_hospital bill auditing experience._** **Responsibilities** ** Medicare Clinical Auditor ** + **Audits outpatient, inpatient ... with payment recovery staff.** + **Performs other duties as assigned.** **Senior Medicare Clinical Auditor ** + **Audits outpatient, inpatient and professional… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- Summary With direction from the Patient Financial Services Director, the Nurse Auditor / Revenue Integrity/ CDM Analyst is responsible for performing audits of ... the billing staff of appropriate HCPCS codes and modifiers. The Nurse Auditor / Revenue Integrity/ CDM Analyst works directly with revenue producing departments… more
- Hackensack Meridian Health (Hackensack, NJ)
- …as a leader of positive change. The **Diagnosis Related Group (DRG) Auditor ** is responsible for auditing clinical documentation that supports code assignment for ... with the Conditions of Participation for CMS. The DRG auditor is responsible for ensuring coding accuracy, coding consistency...with all DRG mandates and reporting requirements. + Monitors Medicare and other DRG payment bulletins and manuals and… more
- HCA Healthcare (Nashville, TN)
- …colleagues invested over 156,000 hours volunteering in our communities. As a Revenue Integrity Auditor RN with Parallon you can be a part of an organization that is ... organization. We are looking for an enthusiastic Revenue Integrity Auditor RN to help us reach our goals. Unlock...and conference calls as required. + Working knowledge of Medicare requirements for the "two midnight rule" + Working… more
- Henry Ford Health System (Troy, MI)
- Reporting to the Manager, Revenue Integrity, the Revenue Integrity Auditor must have a comprehensive understanding of medical terminology, coding, charge entry, and ... healthcare revenue cycle processes. The Revenue Integrity (RI) Auditor provides support for timely, accurate and inclusive charge capture, coding, billing functions… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Quality Auditor II Job Category: Customer Service Department: Even MORE Quality Location: Los Angeles, CA, US, 90017 Position Type: Full ... that purpose. Job Summary The Customer Solution Center Quality Auditor (QA) II is responsible for monitoring and actively...daily error reports, analyze results from Call Center, MRP, Medicare , MRU, Outbound and Outreach, and LA Care Covered… more
- Johns Hopkins University (Baltimore, MD)
- We are seeking a **Sr. Compliance Auditor ** **Trainer** who will provide on-going training and support to physicians, non-physician providers, professional fee ... + Keeps current with third party regulations with emphasis on Medicare billing, teaching physician regulations, Current Procedural Terminology, ICD-9-CM Coding, and… more
- State of Georgia (Fulton County, GA)
- Investigative Auditor - Medicaid Fraud Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/52416/other-jobs-matching/location-only) Hot ... Office of the Attorney General Department of Law Medicaid Fraud - Investigative Auditor *To move forward in the recruiting process ALL applicants are required to:… more
- AdventHealth (Altamonte Springs, FL)
- …you'll contribute:** The inpatient or outpatient coding team Corporate Quality Auditor (QA)/Educator supports the operations of the inpatient or outpatient coding ... to achieve industry best practice levels of performance. The Corporate Quality Auditor will adhere to AdventHealth Corporate Compliance standards, as well as rules… more
- State of Maine, Bureau of Human Resources (Augusta, ME)
- Staff Auditor I Augusta , Maine , United States | Auditor | Full-time | Partially remote Apply by: Nov. 27, 2024 Apply with Linkedin Apply Department of Health ... to its staff. ABOUT THE POSITION: As a Staff Auditor I you will: + Perform professional audit work...grow personally and professionally as you acquire knowledge of Medicare , Medicaid, and Federal grants. REQUIREMENTS: To qualify, you… more
- Fallon Health (Worcester, MA)
- …to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- ... of audits following departmental standards and procedures. **The Internal Auditor will perform or assist in the following:** +...plans by working under the direction of the Lead Auditor or Audit Manager. + Prepare detailed work papers… more
- Nuvance Health (Danbury, CT)
- …(SACO) Physician Audit & Billing, the Senior Inpatient Professional Auditor providesHospital Inpatient and Outpatient coding, billing, and documentation auditing ... rules and regulations consistent with Nuvance Health policies, ie, Center for Medicare & Medicaid Services (CMS), American Medical Association (AMA), American Health… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Trainer/ Auditor 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #11905 Tuesday, November 5, 2024 Centers Plan for Healthy Living's goal is to create the ultimate ... monitoring the field staff on a monthly basis. The Trainer/ Auditor will provide oversight of the field staff. He/she...Managed long term care knowledge + Medicaid knowledge + Medicare knowledge SCOPE INFORMATION # Direct Reports: Training and… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …general nature, level and purpose of the job. The Senior Charge Capture Auditor works closely with clinical departments to ensure compliance with government, payer, ... and analyzing impact. + Attends trainings as required to keep current with Medicare and Medi-Cal coding and compliance guidelines as they pertain to coding, charge… more
- Baylor Scott & White Health (Dallas, TX)
- **JOB SUMMARY** The Access Services Auditor is accountable for improving the accuracy and productivity of the registration, insurance verification, scheduling, and ... Conducts monthly audits on different aspects within Access Services (eg, Medicare Secondary Payer Questionnaire (MSPQ), Advance Beneficiary Notice of Noncoverage… more
- Covenant Health Inc. (Knoxville, TN)
- …of CPT coding, modifiers and billing processes to ensure compliance with Medicare , Medicaid guidelines and other insurance payers and to maximize reimbursement. + ... out-patient and/or physician practice. Good working knowledge of healthcare billing, Medicare /Medicaid billing guidelines, and other Third Party Payor rules and… more
- Highmark Health (Columbus, OH)
- …system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare ... Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician coding and/or… more
- McLaren Health Care (Indianapolis, IN)
- We are looking for a Special Investigative Unit Auditor to join us in leading our organization forward. McLaren Integrated HMO Group (MIG), a division of McLaren ... Indiana-based health plan, working with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and Healthy Indiana… more
- New York State Civil Service (Albany, NY)
- NY HELP No Agency Health, Department of Title Information Systems Auditor (ISA) 1 - 89048 Occupational Category Administrative or General Management Salary Grade 23 ... CMS guidelines; * Support and maintain relationships with the Centers for Medicare and Medicaid Services (CMS), Office of Information Technology Services (ITS),… more
- CommonSpirit Health Mountain Region (Centennial, CO)
- …help you flourish and leaders who care about your success. The Coding Auditor and Educator utilizes ICD-10-CM, HCPCS, and CPT-4 Coding Classification systems who ... fee coding rules and guidelines. + Understand rules and regulations governing Medicare billing. + Advanced Knowledge of NCCI, ICD-10-CM, CPT, HCPCS, and modifiers.… more