- Molina Healthcare (Spokane, WA)
- The Clinical Services Auditor performs auditing of clinical staff in Utilization Management (UM), Case Management (CM), Member Assessment Team (MAT), ... Management (HM), and/or Disease Management (DM) and monitors key clinical staff for compliance with...case management, and understanding of state Medicaid contracts. The Auditor should have the ability to reference/ remember rules,… more
- Humana (Olympia, WA)
- …our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and ... codes (eg, ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis… more
- CVS Health (Olympia, WA)
- … clinical expertise in either written or verbal forms including communication with clinical or coding staff , federal regulators and vendor coding resources. + ... risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal...+ Acts as mentor to provide education to internal staff based on audit findings; provides general education on… more
- Molina Healthcare (Vancouver, WA)
- …and cost-effective member care. Essential Job Duties * Performs audits of non- clinical staff in utilization management, care management, member assessment, ... address findings in audit results. * Meets minimum production standards related to non- clinical auditing. * May conduct staff trainings as needed. * Communicates… more
- Datavant (Olympia, WA)
- …audits. + Develop and implement education for physicians, nursing, and other clinical staff to enhance documentation. + Communicate effectively with co-workers, ... addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding...management, and hospital staff regarding clinical and reimbursement issues. +… more
- Molina Healthcare (Everett, WA)
- …+ Certified Professional in Health Quality (CPHQ) + Nursing License + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are ... not be limited to: Quality Reporting, HEDIS Performance Measurement, Clinical Quality Interventions, and QI Compliance . +...+ Develops training, goals and coaching plans for Quality staff . + Ensures that quality assurance is performed for… more
- Providence (WA)
- …upon hire. + Certification as an Internal Auditor or Healthcare Compliance certification upon hire. + Clinical background. **Salary Range by Location:** ... Audit Special Investigations Unit \*Remote The SIU Audit Investigator supports the compliance related activities of the Special Investigations Unit (SIU) at the… more