- Elevance Health (New Hyde Park, NY)
- Manager of DRG Coding Audit -Program/Project Locations: _The selected candidate must reside within a reasonable commuting distance of the designated ... eliminate and prevent unnecessary medical-expense spending. The ** Manager of DRG Coding Audit ** leads a high-performing team responsible for auditing… more
- Cardinal Health (Albany, NY)
- …and conducts investigations to resolve ethics and compliance issues. **Compliance Audit Manager ** Reporting to the Compliance Director, this position ... well as the development and completion of the annual enterprise risk assessment and audit and monitoring plan. The Manager has supervisory responsibility for all… more
- Datavant (Albany, NY)
- … changes with the appropriate manager . + Prepare the final reports for the coding audit and actively participates in the resolution of audit findings. + ... headset, and keyboard + Comprehensive training led by a credentialed professional coding manager + Exceptional service-style management and mentorship (we're in… more
- Datavant (Albany, NY)
- …headset, and keyboard + Comprehensive training led by a credentialed professional coding manager + Exceptional service-style management and mentorship (we're in ... Types of reviews, using appropriate assignment of codes and other coding -related elements using MS DRG or APR DRGs. + Provides rich and concise rationale… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …CPC designation within one year of hire date. + Knowledge of medical record coding conventions (eg CPT, DRG , HCPCS, ICD10, etc.). + A general understanding ... contracts, group benefit structures, Corporate Medical Policies, the AMA CPT Coding Guidelines, HCPCS coding , inter-plan regulations, government policies, as… more
- Humana (Albany, NY)
- …certification (AHIMA or AAPC - ex: RHIA, RHIT, CCS, CIS, CIC) + Inpatient coding claim experience + Prospective payment methodologies, DRG auditing experience + ... and help us put health first** The Nurse Auditor 2 performs clinical audit /validation processes to ensure that medical record documentation and diagnosis coding … more
- Datavant (Albany, NY)
- …headset, and keyboard + Comprehensive training led by a credentialed professional coding manager + Exceptional service-style management and mentorship (we're in ... codes from patient records, ensuring precision and adherence to documentation + Oversee and audit the work of Level 1 & 2 Coders, where applicable + Champion… more
- Molina Healthcare (Albany, NY)
- …proficiency. **PREFERRED QUALIFICATIONS:** + Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified ... readmissions. + Validates member medical records and claims submitted/correct coding , to ensure appropriate reimbursement to providers. + Resolves escalated… more