- Healthfirst (NY)
- …+ **Conduct moderately complex to complex quality audits of provider claims, pre-payments and post-payments including high-dollar and specialized claims across ... multiple lines of business, claim types and products.** + **Audit the work of more junior auditors and identify opportunities for coaching and//or training.** + **Identify and communicate issues identified through audits and recommended solutions relevant to… more
- Molina Healthcare (Albany, NY)
- …Provides support for claims audit activities including identification of incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and claims ... processing errors. **Essential Job Duties** + Audits the adjudication of claims using standard principles, and state-specific regulations to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing of claims… more
- University of Rochester (Albany, NY)
- …expertise of the individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE Develops, directs, plans and evaluates internal audit programs ... for the organization's information systems and related procedures to ensure compliance with the organization's policies, procedures and standards. Audits information systems applications to ensure that appropriate controls exist and that information produced… more
- Northwell Health (Glen Cove, NY)
- …Validates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record. ... Job Responsibility 1.Leverages clinical expertise to identify and validate DRG code assignment. 2.Full review of CDI suggested code changes 3.Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization.… more
- M&T Bank (Buffalo, NY)
- …+ Lead and participate in audits from planning to reporting and produce quality deliverables in accordance with the Division's methodology and professional standards ... while ensuring timely completion. + Plan and execute other assurance activities (including continuous auditing, product delivery assessments, validation procedures, investigations, and retrospective reviews) utilizing modernized assurance methodologies, tools,… more
- ManpowerGroup (New York, NY)
- …The Internal Audit Manager will be responsible for identifying risks and monitoring critical financial, operational and system processes throughout the organization ... by leading operational, financial, and compliance audits. 1. Preparation of draft reports that summarize the work of internal audit for presentation to management. 2. Planning and managing audit mandates, including documentation of work performed, management… more
- Resource Center for Independent Living (Utica, NY)
- …+ A Bachelor Degree in Human Services, Risk Management, or related field preferred; a High School Diploma or equivalent is required. Relevant experience may be ... considered in lieu of college education. Knowledge, Skills & Abilities: + A minimum of 1 year of related experience in Auditing and/or Compliance tasks. + Proficiency with Microsoft Office is required. + Prior experience with analytical tools and/or statistics… more
- SUNY Upstate Medical University (Syracuse, NY)
- …Under the direction of the Compliance Officer the main duties for this position include: analysis of professional coding and billing data, review of applicable ... regulations or guidelines and professional coding and billing audits. Duties/Responsibilities: Analysis of coding and billing data, identification of trends and aberrations. Performance of routine and investigatory audits evaluating compliance with applicable… more
- Datavant (Albany, NY)
- …skills, experience, and other requirements of the role. The estimated base pay range per hour for this role is: $35 - $45 an hour. Pay ranges for this job title may ... Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health… more
- M&T Bank (Buffalo, NY)
- …+ Lead and participate in audits from planning to reporting and produce quality deliverables in accordance with the Division's methodology and professional standards ... **THIS ROLE WILL NEED TO BE HYBRID 3 DAYS/WEEK OUT OF: BUFFALO NY, BRIDGEPORT CT, or WILMINGTON DE. MUST BE WITHIN A COMMUTABLE DISTANCE OR WILLING TO RELOCATE** **Overview:** + Leads and executes audits over the Bank's Information Technology (IT) Engineering,… more