- Banner Health (OH)
- …different focuses (Facility vs Profee)._ In this **Inpatient Facility-based HIMS Coding Quality Associate** position, you bring your **5 years of acute care ... team that values growth and development! This is a Quality position, not a day-to-day coding production role but...in your attached resume);** + **DRG and PCS Coding, Auditing experience;** + **Bachelors degree or equivalent;** + **Must… more
- Corewell Health (Grand Rapids, MI)
- …will support the organization's cost containment efforts specific to medical claims payment and drive payment integrity performance. This position is responsible ... Payment Integrity Strategy. + Develop/sustain and engagement model between the Claims integrity function and other business units within the organization. +… more
- TEKsystems (Reston, VA)
- Description PURPOSE: The Appeals Specialist II will be responsible for the initial intake analysis of appeals/grievances correspondence and determination of next ... ESSENTIAL FUNCTIONS: 50 Independently researches contractual benefits limitations exclusions and claims to assist medical professional staff in performing the review… more
- Elevance Health (Denver, CO)
- …in applicable state(s). + Requires a minimum of 10 years of experience in claims auditing , quality assurance, or clinical documentation improvement, and a ... The **Diagnosis Related Group Clinical Validation Auditor-RN** is responsible for auditing inpatient medical records to ensure clinical documentation supports the… more
- State of Minnesota (Vadnais Heights, MN)
- …a DCT Revenue Cycle Quality Assurance Analyst! As the DCT Revenue Cycle Quality Assurance Analyst, you will focus on auditing , monitoring, and assessing key ... **Working Title: DCT Revenue Cycle Quality Assurance Analyst** **Job Class: Management Analyst 4**...the revenue cycle, including billing, coding, insurance verification, and claims processing. The goal is to identify areas of… more
- LA Care Health Plan (Los Angeles, CA)
- …Nurse - Payment Integrity Nurse Coder RN III Job Category: Clinical Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... 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… more
- UPMC (Pittsburgh, PA)
- …and DRG assignment appropriateness to ensure consistency and efficiency in claims processing, data collection, and quality reporting. + **Post-Audit ... they meet state and federal regulations. **Key Responsibilities:** + **Comprehensive Auditing :** Conduct UPMC-wide auditing and monitoring to ensure that… more
- Billings Clinic (Billings, MT)
- You'll want to join Billings Clinic for our outstanding quality of care, exciting environment, interesting cases from a vast geography, advanced technology and ... and how we are recognized nationally for our exceptional quality . Your Benefits We provide a comprehensive and competitive...Billings Clinic is an integrated delivery system, responsible for auditing or assigning CPT and E&M codes to clinic… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- …substituted with experience on a one-to-one basis Preferred Experience Coding, auditing or quality assurance review experience. Bilingual (English/Spanish) ... and regulations and UTRGV policies. To review and analyze medical records, claims , and workflow processes to ensure accuracy, completeness, and compliance with… more
- Henry Ford Health System (Detroit, MI)
- …working with one or more of the following areas: Utilization Management, Claims , Pharmacy Operations, Compliance, FDR oversight activities, Quality Management, ... Compliance Audit Manager, the Principal Compliance Investigator will oversee compliance auditing and monitoring to assess and identify compliance risks with Federal… more
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