- Highmark Health (Harrisburg, PA)
- …entities in response to external coding audits conducted by the Medicare Administrative Contractor , the RAC , MIC, ZPIC, etc. Determine appeal action, prepare ... OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and… more
- UL, LLC (Allentown, PA)
- …+ Assess and report in accordance with UL, industry scheme, and client audit protocols on facilities working and/or operational conditions as it relates to ... 21CFR111 + Medical/Homecare Devices: 21CFR820 + Cosmetics: ISO22716 #MB-1 #LI-Remote Complete audit agendas within 14 calendar days of the audit Complete… more
- St. Luke's University Health Network (Allentown, PA)
- …and procedure code assignment and MS-DRG/APR-DRG accuracy based on denials or audit findings from government and commercial payers. Meet or exceed established ... the physician advisor in review of patient medical records identified by RAC /MIC/QIO and other governmental or commercial payor auditors in retrospective reviews for… more
- St. Luke's University Health Network (Allentown, PA)
- …leadership team. Oversees account changes pertaining to accepted and/or appealed audit recommendations and works with staff assisting with clerical and ... administrative tasks related the appeals/ audit function. Identify and provide feedback, including identification of...advisor in review of patient medical records identified by RAC /MIC/QIO and other insurers or outside auditors in retrospective… more
- Wolters Kluwer (Philadelphia, PA)
- …Important responsibilities include cross-functional correspondence, quality management reviews, audit support, change planning, and corrective and preventative ... future issues . Lead Auditor Certified, preferred . Regulatory Affairs Certification ( RAC ), preferred. **TRAVEL:** Travel is minimal and tends to be irregular in… more