- CVS Health (Sacramento, CA)
- …each and every day. Aetna's Revenue Integrity team is hiring Senior Coding Data Quality Auditors to support our growing risk adjustment efforts. This role plays a ... continuous improvement. This position will sit within our Coding Quality Operations team and offers the flexibility of working...mentor to provide education to internal staff based on audit findings; provides general education on ICD codes as… more
- MTC (San Diego, CA)
- …**San Diego Job Corps Center in Imperial Beach, CA** where our staff provide quality services to our local youth. We value our professional and caring employees who ... compliance with government and management directives. **Essential functions:** 1. Evaluate and audit 100% of admissions folders to ensure all required information is… more
- 24 Hour Fitness, INC. (Mountain View, CA)
- …actively training with updated client management processes the FM will ensure the quality of all fitness offerings are met to provide exceptional client experience ... to ensure all trainers successfully pass CCS evaluations + Perform session quality reviews for personal trainers to provide feedback on personal training sessions… more
- Elevance Health (Walnut Creek, CA)
- …and reference information to generate audit determinations and formulate detailed audit findings letters. + Maintains accuracy and quality standards as ... coding principles, clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding expertise, mastery of… more
- The County of Los Angeles (Los Angeles, CA)
- …and develops corrective action plans for deficiencies as noted in the audit report. + Monitors National Practitioner Data Bank reports and maintains integrity ... hearing plans, and any other rules and regulations that reference accreditation, quality control and confidentiality of medical staff documents. + Supports various… more
- The County of Los Angeles (Los Angeles, CA)
- …Submits specific audits to the Compliance department to get approval. Input all audit requests into tracking system and prepares records. Works with tight deadlines ... while dealing directly with audit entities, both private and government, on billing and...for improvement to management. Prevents possible breeches by maintaining quality assurance (QA) for the department. Follows protocol for… more
- Highmark Health (Sacramento, CA)
- …retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, ... identified in the audits compliant with regulatory requirements. Provides written audit guidance. Participates with management in the assessment of external … more
- Sharp HealthCare (San Diego, CA)
- …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 team, responsible for advancing high- quality , patient-centered care through expert oversight of ICM practices. This role supports the daily… 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
- Clay Lacy Aviation (Van Nuys, CA)
- …robust internal controls to prevent errors, fraud, and non-compliance, with audit -ready processes and documentation aligned with applicable regulatory standards. + ... vendor management, contract negotiations, and service-level agreements to ensure high- quality , cost-effective program delivery. + Partner with the Finance team… more