- Elevance Health (Walnut Creek, CA)
- …state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement , and a minimum of ... **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG...and Hospital-Acquired Conditions (HACs). + Suggests and develops high quality , high value, concept and or process improvement… more
- Humana (Sacramento, CA)
- …entry regarding claim/encounter information + Support and participate in process and quality improvement initiatives **What Humana Offers** We are fortunate to ... our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct… more
- Sharp HealthCare (San Diego, CA)
- …Hospital/Facility (CIC), or Certified Professional Coder (CPC) certification.Certified Clinical Documentation Improvement Practitioner or Specialist (CDIP ... matters and other general Compliance reimbursement inquiries.Will continuously evaluate the quality of clinical documentation and monitor the appropriateness of… more
- Cedars-Sinai (Los Angeles, CA)
- …the National Research Corporation's Consumer Choice Award 19 times for providing the highest- quality medical care in Los Angeles. We also were awarded the Advisory ... the general direction of the Manger or Associate Director, the Revenue Auditor Service Line performs audits of medical records against submitted professional… more
- Elevance Health (Los Angeles, CA)
- …Preventable Adverse Events (PAEs) or Never Events. + Suggests and develops high quality , high value concept and or process improvement and efficiency ... **DRG Coding Auditor Principal** **_Virtual: _** _ _ This role...Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad, deep and niche… more
- Sharp HealthCare (San Diego, CA)
- …assure the accurate reporting and documentation of services provided by entity clinical providers. To support and facilitate the implementation of correct coding ... standards by clinical providers as established by SHC Corporate Compliance in...priority concerns.Utilizes internal and professional resource tools to provide quality audit results.Performs concurrent audits according to a defined… more
- Gilead Sciences, Inc. (Foster City, CA)
- …Failure Mode Effects Analysis (FMEA)) is preferred. + Certification by ASQ (Certified Quality Auditor , Certified Quality Engineer, and Certified Quality ... personnel to achieve goals and strategic initiatives. + Executes changes to quality processes to ensure conformance and continuous improvement . + Ensure… more
- Gilead Sciences, Inc. (Foster City, CA)
- …FMEA). + Knowledge of ISO 14971 Risk Management processes. + ASQ certifications (Certified Quality Auditor , Certified Quality Engineer, Certified Quality ... achieve goals and strategic initiatives. + Identify, plan, and execute changes to quality processes to ensure conformance and continuous improvement . + Ensure… more
- Stanford Health Care (Palo Alto, CA)
- …senior member of the team, this individual actively contributes to process improvement initiatives, drives innovation in financial systems, and fosters a culture of ... change, accountability, and continuous improvement . **Locations** Stanford Health Care **What you will do** + Government Payor Reporting & Reimbursement + Ensure… more
- Datavant (Sacramento, CA)
- …in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding education, interim coding ... you to help shape the future of healthcare from your own workspace! Inpatient auditor with 3-5 years of experience at a Trauma Level 1 facility. SMART software… more