- 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 ... + Minimum of five years of related experience. Classified Title: Sr. Billing Compliance Auditor Job Posting Title (Working Title): Sr. Compliance … more
- Nuvance Health (Danbury, CT)
- …within approved working states *Summary:* Reporting to the Special Associate Compliance Officer (SACO) Physician Audit & Billing, the Senior Inpatient Professional ... Auditor providesHospital Inpatient and Outpatient coding, billing, and documentation...units and provides recommendations toward continuing improvement of coding compliance and coding denial management, while ensuring compliance… 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 ... compliance with billing regulations, this includes compliance ...with the Conditions of Participation for CMS. The DRG auditor is responsible for ensuring coding accuracy, coding consistency… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …for Medicare and Medicaid Services (CMS) rules, regulations and compliance guidance required. + Excellent analytic and problem-solving skills to process auditing ... for clinical and operational excellence. **Summary** Works collaboratively with the Compliance Manager on creating auditing protocols which align with Bon Secours… 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
- 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
- AdventHealth (Altamonte Springs, FL)
- …to achieve industry best practice levels of performance. The Corporate Quality Auditor will adhere to AdventHealth Corporate Compliance standards, as well ... you'll contribute:** The inpatient or outpatient coding team Corporate Quality Auditor (QA)/Educator supports the operations of the inpatient or outpatient coding… 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)- ... and objectiveinternal audits and assessments of its operational, financial and compliance controls. IA reports administratively to the Chief ComplianceOfficer and… 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...funds through contracts with DHHS. + Complete financial and/or compliance audits for conformance to established laws, rules, regulations… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …Capture Auditor works closely with clinical departments to ensure compliance with government, payer, and internal charge capture policies; provides education to ... + Attends trainings as required to keep current with Medicare and Medi-Cal coding and compliance guidelines as they pertain to coding, charge items, charge… 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 ... healthy living. JOB SUMMARY: The objective isto ensure ongoing compliance , provide support and training by monitoring the field...monitoring the field staff on a monthly basis. The Trainer/ Auditor will provide oversight of the field staff. He/she… more
- Covenant Health Inc. (Knoxville, TN)
- …research and analysis of CPT coding, modifiers and billing processes to ensure compliance with Medicare , Medicaid guidelines and other insurance payers and to ... OIG advisory opinions, and other publications relative to coding, billing and reimbursement compliance in order to ensure compliance . + Reviews information from… more
- Atlantic Health System (Morristown, NJ)
- …assure appropriateness and accurate code assignments in accordance with Center of Medicare and Medicaid (CMS) guidelines and provide ongoing feedback and analysis of ... the year 9. Audit charts for accurate and correct coding and compliance within documentation guidelines and AMG/AHS policies 10. Prepares written reports of… more
- Highmark Health (Columbus, OH)
- …with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts ... system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare… 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 ... knowledge of existing and emerging guidance from CMS to ensure IT systems maintain compliance for enhanced funding;* Work with project teams on a monthly basis to… more
- Sharp HealthCare (San Diego, CA)
- …coder. + 2 Years experience working as a HCC risk adjustment coding auditor . + Experience with medical billing and with medical terminology. + Certified Professional ... of care following coding rules and regulations.Applies understanding of Medicare , Medi-Cal and other payor guidelines.Identifies documentation deficiencies and… more
- Rising Medical Solutions (Chicago, IL)
- …born - and continues to thrive. Rising Medical Solutions is looking for a Nurse Auditor who wants to make their mark in the world of medical cost containment. Join ... perspective, including appropriate billing, coding and treatment, fee schedule compliance , over-utilization, and erroneous charges. We pride ourselves on outstanding… more
- Northwell Health (Port Jefferson, NY)
- …coding rules and regulations to the validation review process. 6.Reviews codes on Medicare /non- Medicare charts for compliance to rules and conventions. ... and principals; performs coding audits for optimization. 4.Audits and reviews Medicare /non- Medicare charts to ensure that proper standards are maintained… more
- Northwell Health (Garden City, NY)
- …coding rules and regulations to the validation review process. + Reviews codes on Medicare /non- Medicare charts for compliance to rules and conventions. + ... the Medical Record. Job Responsibility + Audits and reviews Medicare /non- Medicare charts to ensure that proper standards...changes necessary to provide the most valid documentation in compliance with Federal and State regulations. + Reports to… more
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