- Humana (Boston, MA)
- …is a full-time, remote/work-from-home position. **Description** The Inpatient Medical Coding Auditor extracts clinical information from medical records and ... Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper reimbursement, handle… more
- Humana (Boston, MA)
- …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
- Elevance Health (Woburn, MA)
- **DRG CODING AUDITOR ** **Location** : _This position will work virtually._ _Alternate locations may be considered._ The **DRG CODING AUDITOR ** is responsible for ... for all lines of business, and its clients. Also responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding… more
- Elevance Health (Woburn, MA)
- **DRG Coding Auditor Principal** _Virtual: This role enables associates to work virtually full-time, providing maximum flexibility and autonomy. This approach ... and skill development. Alternate locations may be considered._ The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid… more
- Highmark Health (Boston, MA)
- …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
- Cognizant (Boston, MA)
- We strive to provide flexibility wherever possible. Based on this role's business requirements, this is a remote position open to qualified applicants in the United ... and compliance with regulatory and organizational standards. - **Enhance Clinical Documentation Quality** . Collaborate with physicians through a structured… more
- Humana (Boston, MA)
- …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
- Baystate Health (Springfield, MA)
- …health Baystate Health, western Massachusetts' only academic center and tertiary care provider has a long and proud tradition of continuous learning and improvement. ... 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
- Sanofi Group (Framingham, MA)
- …possible. Ready to get started? **Main Responsibilities:** + Acts as a lead auditor or co- auditor , in accordance with Sanofi processes. + Facilitates ... on pharma/biotech. + At least five years relevant experience as Quality Auditor . + Direct experience preparing for and supporting Regulatory Inspections from… more
- Commonwealth Care Alliance (Boston, MA)
- …on edits implemented. + Utilize data to examine large claims data sets to provide analysis and reports on existing provider billing patterns as compared to ... Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and necessary coding configuration requirements… more