- Molina Healthcare (San Diego, CA)
- JOB DESCRIPTION Job Summary The Non- Clinical Auditor is responsible for conducting detailed audits of member service interactions, including call recordings ... Qualifications** Utilization management, care management, behavioral health and/or long-term services and supports (LTSS) non- clinical review/auditing experience.… more
- LA Care Health Plan (Los Angeles, CA)
- …net required to achieve that purpose. Job Summary The Risk Adjustment Coding Auditor II position is responsible for auditing clinical documentation and coding ... Risk Adjustment Coding Auditor II Job Category: Accounting/Finance Department: Risk Adjustment...assess accuracy and compliance of coding assignments per the clinical documentation for the various risk adjustment models (Health… more
- Sharp HealthCare (San Diego, CA)
- **Facility:** System Services **City** San Diego **Department** **Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Certified ... Clinical Documentation Specialist (CCDS) - Various-Employee provides certificate; Other;...remote position* **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp… more
- Providence (CA)
- …for Employers and the California Fair Chance Act." **About the Team** Providence Shared Services is a service line within Providence that provides a variety of ... them._** **Providence Health Plan is calling a Coding Quality Auditor , HEDIS who will:** + Be responsible for conducting..., HEDIS who will:** + Be responsible for conducting clinical quality audits/overreads for the Quality Department + Identify… more
- Humana (Sacramento, CA)
- …our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct ... guidance where needed. Follows established guidelines/procedures. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters, and… more
- UCLA Health (Los Angeles, CA)
- …next level. You can do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned to the ... auditor . You will review claims (paid, pending, and denied)...denied) for accuracy, appropriate application of benefits, authorization for services , contract interpretation, Division of Financial Responsibility (DOFR), and… more
- Providence (Torrance, CA)
- …for Employers and the California Fair Chance Act." **About the Team** Providence Shared Services is a service line within Providence that provides a variety of ... **Description** The Revenue Cycle Auditor is responsible for providing patient focused, standardized,...they're invaluable. Join our team at Revenue Cycle Business Services and thrive in our culture of patient-focused, whole-person… more
- Molina Healthcare (Long Beach, CA)
- JOB DESCRIPTION Job SummaryProvides support for non- clinical healthcare services auditing activities. Responsible for performing audits for non- clinical ... * Utilization management, care management, behavioral health and/or long-term services and supports (LTSS) non- clinical review/auditing experience. To… more
- Sharp HealthCare (San Diego, CA)
- …and make recommendations which assure the accurate reporting and documentation of services provided by entity clinical providers. To support and facilitate ... the implementation of correct coding standards by clinical providers as established by SHC Corporate Compliance in accordance to the CMS and local MAC (Medicare… more
- Spread Your Wings, LLC. (Garden Grove, CA)
- …Diego office. 1. Do you have experience of requirements when providing services to Intellectualy Disabled Individuals? 2. Do you have Quality Assurance background? ... projects of the assigned region. Primary functions will include assessing service delivery, documentation compliance, monitoring of client records, and serving as… more