- Elevance Health (Costa Mesa, CA)
- … Auditor -RN** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs billed and reimbursed. ... **Title:** Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG...years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of… more
- Humana (Sacramento, CA)
- …and appropriateness of procedure codes based on services rendered + Review medical documentation for clinical indicators to ensure specific procedures meet ... our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct… more
- Sharp HealthCare (San Diego, CA)
- …Day **FTE** 1 **Shift Start Time** **Shift End Time** Certified Clinical Documentation Specialist (CCDS) - Various-Employee provides certificate; Other; ... ICD-10-CM/PCS coding, DRG coding and CPT coding classification. + Certified Clinical Documentation Specialist (CCDS) - Various-Employee provides certificate… more
- Cedars-Sinai (Los Angeles, CA)
- …the general direction of the Manger or Associate Director, the Revenue Auditor Service Line performs audits of medical records against submitted professional ... bill and performs special audit requests for the department. The Revenue Auditor Service Line performs daily reconciliation of the submitted professional charges by… more
- Cedars-Sinai (Los Angeles, CA)
- …internal and external partners and peer departments such as Coding Operations, Clinical Documentation Integrity (CDI), Payor Revenue Management (PRM), and ... will I be doing in this role?** The Coding Auditor works under the general direction of the Coding...the general direction of the Coding Supervisor. A Coding Auditor is responsible for reviewing encounters in either a… more
- Astrix Technology (El Segundo, CA)
- **GCP Auditor ** Clinical El Segundo, California, US + Added - 04/04/2025 Apply for Job We're partnering with an innovative client in the biotechnology industry, ... and they're on the lookout for a talented ** Clinical Compliance Auditor ** to join their dynamic...and compliance audits, including for-cause audits. + Prepare necessary documentation to support audit activities, including audit plans, reports,… more
- Trinity Health (Fresno, CA)
- …Shift **Description:** Reporting to the Nurse Manager*, Cath Lab, the Nurse Auditor performs thorough chart review of Electronic Medical Records (EMR) ... documentation for inaccuracies, omissions, misspellings, and charge review. As...state of California is required. 3. Four (4) years clinical experience in cardiovascular service environment is required. 4.… more
- WelbeHealth (Sacramento, CA)
- … 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 retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants + Conduct pre-visit chart preparations and post-visit chart reviews + Oversee… more
- Sharp HealthCare (San Diego, CA)
- … practices 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… more
- University of Southern California (Alhambra, CA)
- As the center of clinical charge capture, the Revenue Integrity (RI) Specialist provides leadership to the daily CDM maintenance workflow between the various ... are up to date. The Senior RI Specialist delivers direction to the documentation of all policies and procedures regarding CDM Maintenance and charge process; and… more