- Humana (Albany, NY)
- …with business partners to uphold ethical standards and mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance , ... requires an in-depth evaluation of variable factors. As the Senior Clinical Compliance Professional, you will develop and/or evaluate compliance policies… more
- Mohawk Valley Health System (Utica, NY)
- …Time - 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 ... JOB SUMMARY: The Catholic Health (CH) Health Information Management (HIM) Educator/ Auditor will work cooperatively with CH coding associates, physicians, Inpatient… more
- Healthfirst (NY)
- …classified, and fully resolved in a compliant manner. + Review clinical documentation for accuracy, completeness identifying any discrepancies or non- compliance ... goals. + Maintains tracking tools to log audit results including areas of non- compliance and informing what areas of improvement are needed for discussion with… more
- ICON Clinical Research (Whitesboro, NY)
- Quality Assurance Auditor I - Whitesboro, NY USA (Onsite Hybrid) ICON plc is a world-leading healthcare intelligence and clinical research organization. We're ... us on our mission to shape the future of clinical development. We have an incredible opportunity for a...We have an incredible opportunity for a **Quality Assurance Auditor I** to join ICON's Full Service Bioanalytical Lab… 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 ... oversight of denial processes and educational initiatives. This position combines clinical expertise with advanced system knowledge to manage denials, drive… 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)
- …with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts ... and modifier systems, missed secondary diagnoses and procedures and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim… 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 ... reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. + Applies coding rules and… more
- Cognizant (Albany, NY)
- … compliance with regulatory and organizational standards. - **Enhance Clinical Documentation Quality** . Collaborate with physicians through a structured query ... will make an impact by playing a critical role in ensuring the accuracy, compliance , and quality of ICD-10-CM and ICD-10-PCS coding for inpatient records. You will… more