- Humana (Boston, MA)
- …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
- Humana (Boston, MA)
- …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
- MAPFRE Insurance (Webster, MA)
- …adherence to regulatory requirements, and recommending improvements that drive change. The auditor will also use data analytics to support audit procedures, ... Internal Auditor (Webster or Boston, MA) Date: Nov 22,...IIA standards, ensuring organized and well documented works that support audit conclusions + Contribute to audit planning, kickoff,… more
- Humana (Boston, MA)
- …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
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …member of the Audit and Risk Management (ARM) team, the Senior Internal Auditor will lead and execute a variety of financial, operational, and risk-based audits ... our Flex persona What you'll do: + Conduct or support Model Audit Rule (MAR) and other audits, in...and risk-based audits of these areas (eg Enrollment, Premiums, Claims Operations, Provider Enrollment and Pricing, Accounting, and Information… more
- Commonwealth Care Alliance (Boston, MA)
- …user acceptance testing, and analyze post production reports for issues + Support collaboration between PI/ Claims and other internal stakeholders related to ... claims management, coding rules and guidelines, and evaluating/analyzing claim outcome results for accurate industry standard coding logic and policies… more
- Humana (Boston, MA)
- …Adjustment Operations, including the areas of Provider Data Validation, Provider Support , Provider Reporting, Quality Audit, and risk adjustment operations related ... Bachelor's degree - Accounting, Finance, Business, Auditing, Actuarial + Certified Internal Auditor , CPA or CPC strongly preferred + Risk Adjustment knowledge +… more