- 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
- AdventHealth (Altamonte Springs, FL)
- … Coding Clinic(R), CMS guidelines, NCCI guidance, etc. . Provides outcomes of coding quality audit reviews with leadership . Maintains current knowledge ... as supporting on-going quality assurance needs for coding staff. They will review medical records...and/or outpatient coding policies, procedures, and established audit schedule; translates quality auditing results into… more
- R1 RCM (Chicago, IL)
- …this role you must have:** + 5+ years outpatient facility coding experience + Coding quality audit experience specific to outpatient coding + ... training of all OP new hires in the modular coding department. Job shadowing, casework review , milestone...associated with this position. + Responsible to conduct the quality review of production coders on a… more
- LifePoint Health (Brentwood, TN)
- …guidelines for billing and coding . . Monitor and supervise personal coding quality review engagement scheduling and progress of reviews; ... * Review Specialist, Coding Quality ...* Review Specialist, Coding Quality & Education* *Who we...coding professional based on the findings of the coding quality reviews. . Prepare audit… more
- Columbus Regional Hospital (Columbus, IN)
- …new coding initiatives. + Proactively identifies areas of opportunity to improve coding quality based on audit feedback, coder questions, physician ... for diagnoses and services performed (HCPCS/CPT codes). + Develops quality audit reports that identify trends and...provider education accordingly. + Assists in the formulation and review of policies and guidelines affecting the coding… more
- Zelis (NJ)
- Position Overview: At Zelis, the Itemized Bill Review Facility Reviewer is responsible for analyzing facility inpatient and outpatient claims for Health Plans ... progression + Complete claims processing after the Clinical Bill Review and Audit analysis is completed. +...guidelines including Official Coding Guidelines and AHA Coding Clinic and share with review team… more
- Magellan Health Services (Baton Rouge, LA)
- …other clinical staff. + Provides training, interpretation and support for QI Clinical Reviewer staff. + Audits and validates internal audit results and/or ... record documentation. + Conducts ongoing activities which monitor established quality of care standards in the participating provider network...a team member. Knowledge of ICD and DSM IV coding or most current edition. Ability to analyze specific… more
- City of New York (New York, NY)
- …all statutory, regulatory and contractual standards. Within AO, is the Office of Quality Assurance & Fiscal Integrity conducts complex internal audits and quality ... identify areas of programmatic deficiencies. Within that area is the Process Evaluation Review Team (PERT). The unit analyzes error trends and determines the need… more
- City of New York (New York, NY)
- …IN THE PRINCIPLE ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE. The Office of Quality Assurance & Fiscal Integrity ensures the integrity, efficiency, and regulatory ... legal and federal, state and city regulatory requirements. The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with… more
- City of New York (New York, NY)
- …THE PRINCIPAL ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE. The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with ... and agreements (Reynolds, Lovely H., MKB, Dajour, Davila, Brown, etc). Convert audit findings into reports that is presented to Family Independence Administration… more
- R1 RCM (Detroit, MI)
- The Inpatient Coding Quality Reviewer will be...results. Responsibilities + Audits records as defined in the coding quality review plan. + ... review of cases flagged by the PwC SMART coding quality monitoring software tool, maintain required...self-starter. **Desired Qualifications** : Two (2) years of inpatient coding audit experience is preferred. Experience in… more
- R1 RCM (Boise, ID)
- …Manager, IP Coding Quality . **Responsibilities:** + Audits records as defined in the coding quality review plan. Review cases flagged by the ... POA, discharge disposition and DRG assignment + Perform retrospective coding quality reviews as requested + Follows,...self-starter **Desired Qualifications:** + Two (2) years of inpatient coding audit experience is preferred + Experience… more
- Corewell Health (Southfield, MI)
- …and Coding Audit ; Inpatient, Outpatient, Emergency and Professional Coding Performs quality and compliance audits. Reviews medical record documentation ... line coders, office staff and physicians. (Facility and Professional coding ), review of denials and rejections including...of denials and rejections including HIM work queues, complex coding issues, and quality initiatives. + Maintains… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …minimize risk related to external auditors (ex: RAC, MIC, ZIP, etc.) regarding quality , profiling, coding and reimbursement measures. * Lead the communication ... and objectives of the department. * Manage the PSI/HAC review program in conjunction with Quality Performance...* Develop and plan educational programs to providers about quality documentation, ICD coding , profiling and hospital… more
- Atlantic Health System (Morristown, NJ)
- Responsible for coding quality audits of all records (outpatient, inpatient, procedures, testing) to assure appropriateness and accurate code assignments in ... coding trends found during chart reviews, third party audit findings, and annual coding updates. 6....rejections from recurring. 7. Meets with the providers to review the audit findings and to recommend… more
- Healthfirst (NY)
- …and AVP. + Maintains statistics on coding accuracy and provides monthly summaries of coding audit results + Acts as a resource on coding issues and ... notes and assigns correct procedure and diagnosis codes. + Review and analyze new ICD10 coding guidelines,...coding guidelines on all the specialties. + Reviews audit results to identify and analyze trends, recommend and… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- …to queries. . Responsible for audit planning and execution. Develops comprehensive audit plans to review coding and billing practices. Responds to ... and implement methods to maximize efficiency and compliance related to coding , billing, accounts receivable, and reimbursement processes and procedures. Job… more
- Providence (OR)
- …the best people, we must empower them._** **Providence Health Plan is calling a Coding Quality Auditor, HEDIS who will:** + Be responsible for conducting ... Information Set (HEDIS) program + Conduct Audits inclusive of review of outpatient medical records, hospital records, clinical lab...+ **This posting is for multiple openings of a Coding Quality Auditor, HEDIS** + **This position… more
- Hartford HealthCare (Farmington, CT)
- … coding guidelines *_Working Relationships:_* *This Job Reports To (Job Title):*HIM Coding Quality Manager . Follows H3W Leadership Behaviors** . Abides by ... other resources as appropriate. . Assists with processing HIM Coding validation denial and audit finding letters...leadership, as required.** Internal: . Strong working relationships with Coding Quality and Education, medical staff, HIM… more
- Mount Sinai Health System (New York, NY)
- …computer-assisted coding software. + Demonstrates the ability to create and utilize the coding audit tools required to include the facilitation of coding ... to coding to physicians. A participant in coding document review and staff training; reports...+ Provides written reports to supervisor or manager with audit results. Documents any coding deficiencies noted.… more