- Elevance Health (Walnut Creek, CA)
- **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually ... an accommodation is granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records… more
- BeOne Medicines (Emeryville, CA)
- General Description: This position within R&D Quality is a senior Auditor role (as Lead or Co- auditor ) who is responsible for independently overseeing and ... play a critical role in safeguarding the integrity, safety, and quality of clinical research processes and data. This position requires: + Extensive knowledge and/or… more
- UCLA Health (Los Angeles, CA)
- Description Take on an important role within a world-class health organization. Provide specialized expertise that enables the efficient operation of a complex ... this and more at UCLA Health. The Claims Quality Auditor will be responsible for the daily audit of...in the development of breakthrough medical research and outstanding clinical professionals. If you're looking to experience greater challenge… more
- Sharp HealthCare (San Diego, CA)
- …communicates coding discrepancies to management; works to improve overall provider accuracy. **Required Qualifications** + High School diploma or equivalent ... + 2 years' experience working as an HCC risk adjustment coding auditor . + Experience with medical billing, medical terminology, understanding of medical… more
- Datavant (Sacramento, CA)
- …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 ... purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity...severity of a patient's health stats, **You will:** + Provide education through detailed feedback within audits. + … more
- Highmark Health (Sacramento, CA)
- …as needed. Attends meetings and interacts with management to resolve issues and provide advice on new programs. Provides guidance to system entities in response to ... and disease processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and assistance from management,… more
- Humana (Sacramento, CA)
- …us put health first** CenterWell Senior Primary Care (PCO) is a growing provider organization that currently operates about 340+ senior focused primary care centers ... business partners to uphold ethical standards and mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance, by ensuring… more
- CVS Health (Sacramento, CA)
- …purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and ... such evidence across internal stakeholders with varying knowledge and clinical expertise in either written or verbal forms including...and vendor coding resources. + Acts as mentor to provide education to internal staff based on audit findings;… more
- Humana (Sacramento, CA)
- …us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of medical records and assigns appropriate ... be provided a bi-weekly payment for their internet expense. * Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet… more
- Spread Your Wings, LLC. (Garden Grove, CA)
- …* Paid vacation time * Paid sick time * and more Summary: + Provide monitoring, and evaluation of various departments and projects of the assigned region. Primary ... + Reviewing all client records (Master binders, etc.) and other relevant clinical documents and files, in client homes and/or program office locations. +… more