- Humana (Boston, MA)
- …our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and ... codes (eg, ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …with the Plans' provider agreements and the National Healthcare guidelines. The Professional Auditor helps improve clinical outcomes and quality of care, to ... healthcare? Bring your true colors to blue. About the Role: The Professional Auditor is responsible for post-pay review to verify the accuracy of claims… more
- Elevance Health (Woburn, MA)
- **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This role enables associates to work virtually full-time, with the exception of required in-person training ... recover, eliminate and prevent unnecessary medical-expense spending. The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records and generating… more
- CVS Health (Boston, MA)
- …purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and ... confidently speak to such evidence across stakeholders with varying knowledge and clinical expertise in either written or verbal forms including communication with … more
- WelbeHealth (Boston, MA)
- …culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by ... clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. **Essential Job Duties:** + Assist with… more
- Datavant (Boston, MA)
- …educational and life experiences to realize our bold vision for healthcare. As an Auditor , HCC Risk Adjustment Coder, you will review medical records to identify and ... and reimbursement purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity and severity of… more
- Robert Half Accountemps (Boston, MA)
- …leadership, healthcare administration, or corporate healthcare roles. Requirements Featured Opportunity: RN Auditor / Clinical Reviewer + Work for a Fortune 500 ... of experienced Registered Nurses. They're seeking RNs to step into impactful non- clinical roles - including chart review, clinical auditing, utilization… more
- Baystate Health (Springfield, MA)
- …work is administrative. **Job Responsibilities:** **1)** Performs detailed reviews of clinical documentation for provider services using MDAudit based on determined ... coding; applicable use of all carrier guidelines and review of clinical documentation. **5)** Receives and screens incoming correspondence, reports, memos, etc.,… more
- Baystate Health (Springfield, MA)
- …to unit and also as a business partner to the department and clinical staff. Orients patients and families to the unit, answering routine questions. Observes ... also as a business partner to the department and clinical staff. Orients patients and families to the unit,...C Word, OA Gold, SMS, CIS, Premise, BMD, PCM Auditor , People Soft and Staples, and Kronos access if… more
- Baystate Health (Westfield, MA)
- …visitors to unit and also as a business partner to the department and clinical staff. Orients patients and families to the unit, answering routine questions. Able to ... C Word, OA Gold, SMS, CIS, Premise, BMD, PCM Auditor , People Soft and Staples and Kronos access if...related paperwork in conjunction with RN. Screen calls for clinical team and facilitates communication of information requested. **5)**… more