- Mount Sinai Health System (New York, NY)
- **Job Description** ** Clinical Revenue Auditor -CDM Patient Financial Services-Corporate-Full-Time-Days-Option to work remote or hybrid.** The Clinical ... financial health and compliance of the organization and bridges the gap between clinical care and medical billing and reimbursement. This position will report to the… more
- Centene Corporation (New York, NY)
- …Diagnosis Related Group (DRG) and Medical Record Audit Programs for Fidelis Care. The Clinical Coding Auditor & Trainer position is primarily remote with a small ... work performed by staff and present findings and recommendation for areas of improvement to management + Under minimal supervision responsible for all aspects of… more
- Albany Medical Center (Albany, NY)
- …assess compliance with related rules and regulatory requirements, and to identify clinical documentation improvement opportunities. + Identify trends based on ... Day (United States of America) Salary Range: $60,367.47 - $90,551.20 Professional Coding Auditor will apply an advanced professional coding skill set to act as a… more
- Datavant (Albany, NY)
- …educational and life experiences to realize our bold vision for healthcare. As an Auditor , HCC Risk Adjustment Coder, you will review medical records to identify and ... and reimbursement purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity and severity of… more
- Molina Healthcare (NY)
- …measurement. + Experience with clinical intervention concepts, design of quality improvement projects (QIPs), advanced QI concepts, identification of target ... report to Molina's Georgia Health Plan and requires residence in Georgia. Molina's Quality Improvement function oversees, plans, and implements new and existing… more
- University of Rochester (Rochester, NY)
- …for Quality (ASQ), Certified Regulatory Affairs Certification (RAC), or Certified Quality Auditor (CQA) upon hire preferred. The University of Rochester is ... individual, and internal equity considerations._ **Responsibilities:** General Purpose Leads the Quality Assurance team for clinical research conducted at CHeT.… more
- Catholic Health (Buffalo, NY)
- …reflection, reasoning or communication as a guide to action + Knowledge of Quality Improvement , Root Cause Analysis, CMS and Joint Commission regulations + ... varied hours based on role of management and oversight of team Summary: The Clinical Denials and Appeals, Clinical Supervisor is responsible for the people,… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …II (in addition to Level I Essential Accountabilities) + Handles all member clinical condition management programs. + Offers process improvement suggestions and ... Services (CMS), Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards, as appropriate to the member's case… more
- Datavant (Albany, NY)
- …in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding education, interim coding ... to help shape the future of healthcare from your own workspace! Preferred: Inpatient auditor with 3-5 years of experience at a Trauma Level 1 facility. SMART… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and represents non- clinical staff in discussions with Medical Directors and/or clinical consultants. + Serves as an internal auditor /peer reviewer for new ... of the SIU Management, this position is responsible for the accurate and thorough clinical investigation of potential fraud, waste and abuse (FWA) for all lines of… more