- City of New York (New York, NY)
- …with all statutory, regulatory and contractual standards. The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with ... Principal Administrative Associate, to function as a Senior Case Reviewer who will: - Conduct legally mandated case reviews...(Reynolds, Lovely H., MKB, Dajour, Davila, Brown, etc). Convert audit findings into reports that is presented to Family… more
- Excellus BlueCross BlueShield (Rochester, NY)
- … principles, clinical guidelines, and objectivity in the performance of medical audit activities. Draws on advanced ICD-10 coding expertise. Clinical guidelines, ... and claims processing platform. . Manages case volumes and review / audit schedules, prioritizing case load as assigned...quality assurance, or recovery auditing, of (MS/APR) DRG coding for hospital or other acute facility setting. .… more
- Datavant (Albany, NY)
- …you will be instrumental in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding ... references for accurate DRG and APC assignment. + Review non-CC/MCC records to assess proper coding ...appropriate manager. + Prepare the final reports for the coding audit and actively participates in the… more
- Datavant (Albany, NY)
- …you will be instrumental in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding ... of healthcare from your own workspace! **Preferred: Seeking Inpatient Audit Specialist. Would like a candidate that is strong...must have a CCS and 5 years of experience coding and/or auditing and strong spinal fusion experience as… more
- Capital One (New York, NY)
- … Audit function is a dedicated group of professionals focused on delivering top- quality assurance services to the organization's Audit Committee. Audit ... Senior Tech Audit Manager - Global Payment Network Capital One's...the effectiveness of existing controls, identify and define issues, review and analyze evidence, and document client processes and… more
- Capital One (New York, NY)
- … Audit function is a dedicated group of professionals focused on delivering top- quality assurance services to the organization's Audit Committee. Audit ... a collaborative, agile environment to deliver value-added opinions and recommendations. Audit 's vision to provide high value, independent, proactive insights, to… more
- Coinbase (Albany, NY)
- …and fully supported. *_* *Team / Role Paragraph:* Coinbase is looking for an Internal Audit IT Senior to join the Internal Audit team focusing primarily on ... US (Remote) and will be reporting to an Internal Audit IT Senior Manager. The individual will be responsible...to maximize meetings utility, testing efficiencies and internal controls review coverage across the organization. * Serve as a… more
- Datavant (Albany, NY)
- …you will be instrumental in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding ... IR, Spinal and Orthopedics. **What You Will Do:** + Performs Outpatient Facility coding audits of medical records and abstracts using ICD-10-CM, CPT, HCPCS, and… more
- Molina Healthcare (Buffalo, NY)
- …review , long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant ... **Job Summary** Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory… more
- Weill Cornell Medical College (New York, NY)
- …audit findings into targeted education, addressing root causes of documentation and coding deficiencies. + Manage and track Compliance Audit Reports and ... The Compliance Education Manager plays a critical role in aligning education and audit strategies to support the compliance framework. This role is responsible for… more