- HCA Healthcare (Nashville, TN)
- …our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Coding Quality Audit Reviewer with Work from Home you ... in our organization. We are looking for an enthusiastic 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 (Nashville, TN)
- …based 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
- Molina Healthcare (Bowling Green, KY)
- …analytical team; requires decision making pertinent to clinical experience + Documents clinical review summaries, bill audit findings and audit details in ... appropriate/accurate billing and claims processing. + Identifies and reports quality of care issues. + Assists with Complex Claim...two years of experience in Claims Auditing, Medical Necessity Review and Coding experience + Familiar with… more
- Elevance Health (Nashville, TN)
- …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
- Intermountain Health (Nashville, TN)
- …record data using International Classification of Diseases Clinical Modification and Procedure Coding System (ICD-10-CM and PCS) at an advanced level of complexity. ... expertise to work alongside and collaborate with Clinical Documentation Integrity to review complex inpatient facility encounters and assign ICD-10 CM and PCS codes… more
- United Therapeutics (Nashville, TN)
- …safety data collection, management and reporting for postmarketing ICSRs for efficiency, quality , and compliance impacts. This role is critical in ensuring that ... PM case processing operations team + Operational Oversight and Quality Assurance: Oversee day-to-day quality and compliance...support for recruitment process (as needed) + Inspection and Audit Management: Act as the point of contact for… more
- HCA Healthcare (Nashville, TN)
- …analysis services to business partners. The focus of this position is to review , analyze, and evaluate business systems, processes, services, in which the business ... to develop timelines and manage project risks, assist in the development of quality assurance test plans, and help develop end user documentation. This position… more
- Molina Healthcare (Bowling Green, KY)
- …operations and contracted vendor(s) to assure a smooth workflow exists, quality assurance measures are designed and monitored, appropriate handoffs to functional ... abuse. Responsibilities may include data mining and data analysis, developing audit tools based on regulatory and contractual requirements, summarizing and approving… more
- Cardinal Health (Nashville, TN)
- …drive business value. Application Development & Maintenance performs configuration or coding to develop, enhance and sustain the organization's software systems in ... Sr Engineer of Rebates & Incentives for Pharma IT performs configuration or coding to develop, enhance and sustain the organization's software systems in a… more
- Takeda Pharmaceuticals (Nashville, TN)
- …Senior Manager Clinical Data Management is responsible for timely and high quality data management deliverables supporting the Takeda portfolio. They are responsible ... and deliverables are met with the highest degree of quality . + Partners with appropriate stakeholders and CRO partners...leads and manages clinical trial data collection set-up, data review , and database lock: Works with other functions to… more
- Wondr Health (Nashville, TN)
- …content and coaching, the company's flexible and scalable solutions engage populations, improve quality of life and health outcomes, and prevent and reduce the cost ... that developers are trained in and are following secure coding practices as well as privacy-by-design standards. + Monitor...completion of company-wide compliance education. + Direct research and review of complex issues. + Oversee the contract … more