- Humana (Springfield, IL)
- …of our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure ... Follows established guidelines/procedures. **Where you Come In** The Medical Coding Auditor reviews medical claims submitted against medical records provided,… more
- Elevance Health (Chicago, IL)
- …documentation purposes (eg, letter writing) on lower level auditors. + Identifies new claim types by identifying potential claims outside of the concept where ... **DRG Coding Auditor Principal** **_Virtual: _** _ _ This role...Principal** is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology,… more
- Elevance Health (Chicago, IL)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... Validation Audit setting or hospital coding or quality assurance environment preferred . + Broad knowledge of medical claims billing/payment systems… more
- Rush University Medical Center (Chicago, IL)
- …model to other coding staff. * Strong communication and organizational skills. ** Preferred Job Qualifications:** * Certified Professional Medical Auditor (CPMA) ... a key role in the Revenue Integrity team, the Auditor & Educator is responsible for conducting reviews of...focused educational programs on the results of auditing, review claim denials pertaining to coding, and implement corrective action… more
- Humana (Springfield, IL)
- …Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider ... caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns… more
- Elevance Health (Chicago, IL)
- **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually full-time, ... granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor -RN** is responsible for auditing inpatient medical records to ensure clinical… more
- Humana (Springfield, IL)
- …caring community and help us put health first** The Inpatient Medical Coding Auditor reviews a variety of medical records and to determine appropriate procedural ... terminology and medical codes (eg, ICD-10-CM, CPT.) The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the… more
- Humana (Springfield, IL)
- …Bachelor's degree - Accounting, Finance, Business, Auditing, Actuarial + Certified Internal Auditor , CPA or CPC strongly preferred + Risk Adjustment knowledge ... + Auditing experience + Familiarity with CMS Reimbursement models and claims /encounter submission processes + Data analysis and dashboarding experience + People… more
- RKON (Chicago, IL)
- …and service-provider risk + Experience managing multiple clients in parallel. Preferred Technical and Professional Expertise + Microsoft data governance and ... access management and zero trust strategies. + Cyber insurance readiness and claims advisory. + M&A cyber due diligence and post-close security integration. +… more