- Humana (Boston, MA)
- …receives guidance where needed. Follows established guidelines/procedures. + Review medical documentation for clinical indicators to ensure correct coding ... 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
- Datavant (Boston, MA)
- …adjustment and reimbursement purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity and ... 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… more
- Merck (Boston, MA)
- …Skills:** Accountability, Accountability, Adaptability, Audits Compliance, Business Processes, Clinical Documentation , Clinical Quality Management, ... and saving lives around the world. Our Research & Development Division QA Clinical Quality (CQ) provide independent assurance that our Company ensures the safety,… more
- Baystate Health (Springfield, MA)
- …all business functions related to processing patient information, managing documentation , organizing patient medical record and facilitating smooth unit operations. ... 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… more
- CVS Health (Boston, MA)
- …Eastern and Central time zones._ **Job Summary:** The NCQA Accreditation Auditor is responsible for evaluating healthcare organizations' compliance with NCQA ... and supporting quality activities. This role involves conducting audits, preparing documentation , and collaborating with internal teams, as well as external… more
- Baystate Health (Springfield, MA)
- …all business functions related to processing patient information, managing documentation , organizing patient medical record and facilitating smooth unit operations. ... 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 (Springfield, MA)
- …all business functions related to processing patient information, managing documentation , organizing patient medical records, and facilitating smooth unit ... 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
- Datavant (Boston, MA)
- …audits. + Develop and implement education for physicians, nursing, and other clinical staff to enhance documentation . + Communicate effectively with co-workers, ... the future of healthcare from your own workspace! Inpatient auditor with 3-5 years of experience at a Trauma...assess proper coding or identify the need for additional documentation . Scrutinizes all HCPCS and CPT codes influencing APC… more
- Astellas Pharma (Westborough, MA)
- …range of disease indications, ranging from macular degeneration (currently in clinical trials) and other ocular indications to vascular and autoimmune disease. ... Cell Therapy Manufacturing facility in Westborough, MA as products move through clinical trials and commercialization. The Validation Manager will be a leader and… more
- Commonwealth Care Alliance (Boston, MA)
- …Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and necessary coding configuration requirements ... Responsibilities:** + Develop enhanced, customized prospective claims auditing and clinical coding and reimbursement policies and necessary coding configuration… more