- CVS Health (Sacramento, CA)
- …regulators and vendor coding resources. + Acts as mentor to provide education to internal staff based on audit findings; provides general education on ICD codes ... Aetna's Revenue Integrity team is hiring Senior Coding Data Quality Auditors to support our growing risk adjustment efforts.... inter-rater review audits of medical records coded by internal team, as well as external vendor (if applicable)… more
- Highmark Health (Sacramento, CA)
- …Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal , concurrent, prospective and retrospective coding audit activities. ... identified in the audits compliant with regulatory requirements. Provides written audit guidance. Participates with management in the assessment of external … more
- The County of Los Angeles (Los Angeles, CA)
- …are distributed to hospital staff in a timely manner. + Conducts routine internal audits of the review process to ensure compliance with regulatory agencies; assures ... and develops corrective action plans for deficiencies as noted in the audit report. + Monitors National Practitioner Data Bank reports and maintains integrity… more
- Sharp HealthCare (San Diego, CA)
- …of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and ... employer business practices. **What You Will Do** The Sr Specialist Integrated Care Management is a key member of the Integrated Care Management (ICM) leadership… more
- Clay Lacy Aviation (Van Nuys, CA)
- …compliance, and mitigate risk across all programs and systems. + Lead audit and compliance activities with internal and external stakeholders. Competencies ... reducing manual intervention and cycle times. + Design and enforce robust internal controls to prevent errors, fraud, and non-compliance, with audit -ready… more
- Jet Aviation (CA)
- …compliance, and mitigate risk across all programs and systems. + Lead audit and compliance activities with internal and external stakeholders. **Competencies ... reducing manual intervention and cycle times. + Design and enforce robust internal controls to prevent errors, fraud, and non-compliance, with audit -ready… more
- LA Care Health Plan (Los Angeles, CA)
- …the right time. Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents ... Summary The Authorization Technician II supports the Utilization Management (UM) Specialist by handling all administrative and technical functions of the… more
- Sharp HealthCare (San Diego, CA)
- …a key resource for documentation requirements for risk adjustment HCCs, RAF, and/or quality measures. Develop and build relationships with internal and external ... or Equivalent; Certified Professional Coder (CPC) - AAPC; Certified Coding Specialist (CCS) - The American Health Information Management Association (AHIMA);… more
- Solar Turbines Incorporated (San Diego, CA)
- …impact on improving and sustaining supplier performance with impact to quality , cost, delivery, and ultimately to customer commitments and satisfaction. ... a sense of urgency and is diligent in providing timely support to internal clients and external customers. This individual operates in compliance with corporate and… more
- BMO Financial Group (San Francisco, CA)
- …the documentation, reporting and data requirements are addressed satisfactorily and internal control standards, including adherence to audit , regulatory and ... Risk, LOB and credit product partners by being able to conduct quality analysis, address issues appropriately, balance client needs and risk appetite, collaborate… more