- Highmark Health (Springfield, IL)
- …(Outpatient): Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or ... related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding,… more
- R1 RCM (Chicago, IL)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our **Coding Auditor ** , you will help ensure accurate medical coding and ... and E/M coding as demonstrated through work experience as a medical coding auditor for profee, outpatient, and facility encounters For this US-based position,… more
- Humana (Springfield, IL)
- …of our caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of medical ... in-depth evaluation of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis related group (DRG)… more
- Elevance Health (Chicago, IL)
- …formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **DRG CODING AUDITOR ** is responsible for ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This...its clients. Also responsible for performing clinical reviews of medical records and other documentation to evaluate issues of… more
- Elevance Health (Chicago, IL)
- …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Provider Auditor II** is responsible ... **Clinical Provider Auditor II** **Supports the Payment Integrity line of...control. + Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools… more
- Datavant (Springfield, IL)
- …vision for healthcare. **What We're Looking For:** As an HCC (Hierarchical Condition Category) Auditor you will review medical records that have been coded in a ... a diagnosis level + Answer rebuttals entered on the auditor by coders and or auditors + Participate in...CIC or CRC) + A strong knowledge base of medical terminology, medical abbreviations, pharmacology, and disease… more
- CVS Health (Springfield, IL)
- …CRC (Certified Risk Adjustment Coder) required. + CPMA (Certified Professional Medical Auditor ) **or** CDEO (Certified Documentation Expert Outpatient) ... **Position Summary** Responsible for conducting complex audits, reviews and assessments of medical records coded by internal teams prior to the submission to the… more
- AON (Chicago, IL)
- …compliance with corporate policy and designated laws and regulations. The Senior Auditor is a developing audit professional who is primarily responsible for ... the adequacy of internal controls in both design and application. The Senior Auditor is also responsible for performing advisory project work, such as assisting in… more
- GE HealthCare (Chicago, IL)
- …GE HealthCare Audit Committee. Reporting to the Business Audit Manager, the Business Auditor will interact with key process owners and colleagues across GEHC. The ... Business Auditor will be responsible for completing audits and projects...a flexible schedule. GE HealthCare is a leading global medical technology and digital solutions innovator. Our mission is… more
- Elevance Health (Chicago, IL)
- …is granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure ... **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This...an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in… more