- Healthfirst (NY)
- …classified, and fully resolved in a compliant manner. + Review clinical documentation for accuracy, completeness identifying any discrepancies or non-compliance ... issues + Record/track quality assessment scores and provide feedback to reduce errors and improve processes and...evaluating and analyzing aggregate quality performance data + Apply clinical and critical thinking skills to evaluate the quality… more
- Centene Corporation (New York, NY)
- … documentation, and modify business processes to measure member outcomes. Assess provider performance and quality of care through clinical case reviews. ... + Lead clinical audits for provider medical records both remotely via electronic medical records...quality services + Lead case reviews to assess the clinical performance provided in the provider network,… more
- Mohawk Valley Health System (Utica, NY)
- CDI III Educator Auditor - Full Time - Days Department: CLINICAL DOCUMENTATION IMPROVE Job Summary The CDI III Educator Auditor ( Clinical Documentation ... educational program development, and provider education. Core Job Responsibilities Provider Interaction and Clinical Documentation Review + Creates and… more
- Humana (Albany, NY)
- …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
- Mohawk Valley Health System (Utica, NY)
- …- Days Department: MEDICAL GROUP ADMINISTRATION Job Summary The Medical Group Coding Auditor and Educator is responsible for auditing clinical documentation and ... on coding best practices, documentation requirements, and payer-specific guidelines. The Auditor will apply expertise in coding principles, identify areas for… more
- Catholic Health (Kenmore, NY)
- …consistent, accurate, and meets data integrity for use in billing, reimbursement, clinical outcomes, and for SPARCS reporting. The Educator/ Auditor will monitor ... with coding conventions, billing rules and Federal and State regulations. The Educator/ Auditor will also provide timely education and feedback for Physicians,… more
- Lotte Biologics USA LLC (Syracuse, NY)
- …to reliably deliver benefits for patients worldwide. Position Summary The External Auditor , Supplier Quality and Quality Systems, is responsible for supporting the ... (SCN) program, and supplier qualification program for commercial and clinical material suppliers, third-party contract testing laboratories, IT Application… more
- Highmark Health (Albany, NY)
- …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
- Northwell Health (Westbury, NY)
- …a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist- Clinical . Conducts Home Health Resource Group (HHRG) Validation to ensure the ... + Instructs professional staff in code changes, as needed. + Assists clinical staff and nursing supervisors in providing appropriate documentation in the Medical… more
- Northwell Health (Westbury, NY)
- …HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist- Clinical . Job Responsibility 1.Leverages clinical expertise to identify and ... the coding and CDI staff. 8.Identifies appropriate coding changes necessary to provide the most valid documentation in compliance with Federal and State regulations.… more