- Sanford Health (Sioux Falls, SD)
- …including but not limited to: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Professional Medical Auditor (CPMA), Certified ... * Auditing / Evaluation / Investigation The day to day work of a compliance specialist is managing projects of varying scopes from start to end. Key accountabilities… more
- Datavant (Providence, RI)
- …you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, 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
- Corewell Health (Grand Rapids, MI)
- Step into a pivotal role as a Compliance Partner at Corewell Health - serving as a trusted strategic advisor and key voice in advancing our culture of integrity and ... system-wide initiatives, assess risk, and shape the future of compliance at every level. Acting as both consultant and...- AAPC American Academy of Professional Coders Or + CRT- Coding Specialist (CCS) - AHIMA American Health Information Management… more
- Commonwealth Care Alliance (Boston, MA)
- …Working under the direction of the Sr. Director, TPA Management and Claims Compliance , Healthcare Medical Claims Coding Sr. Analyst will be responsible for ... health care programs and reimbursement methodologies (Medicaid and Medicare) + Medical Coding , Compliance , Payment Integrity and Analytics + Direct and relevant… more
- Capital One (Mclean, VA)
- …information, issues and audit progress to teammates, clients and auditor -in-charge. + Perform various aspects of engagement administration, including hours ... innovation, and technology will only make you a better auditor . This will require leveraging the power of data...including 1 year of experience in test scripting or coding (writing, reviewing, or assessing) + At least 2… more
- Capital One (Mclean, VA)
- …information, issues and audit progress to teammates, clients and auditor -in-charge. + Perform various aspects of engagement administration, including hours ... innovation, and technology will only make you a better auditor . This will require leveraging the power of data...and anomalies, including 1 year experience in test scripting, coding (writing, reviewing, or assessing) or a combination +… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …investigating and remediating allegations of FWA while adhering to compliance and regulatory requirements. Primary activities include substantiating referrals, case ... contracts, group benefit structures, Corporate Medical Policies, the AMA CPT Coding Guidelines, HCPCS coding , inter-plan regulations, government policies, as… more
- Trinity Health (Livonia, MI)
- …of applicable federal, state & local laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & ... Revenue Integrity colleagues including areas of opportunity. Assist Nurse Auditor and/or other stakeholders with denial related charge reviews,...or GED + Minimum three (3) years of relevant coding and charge control work experience in a hospital… more
- YMCA of Greater Seattle (Seattle, WA)
- …: coordinate monthly spend-downs, validate federal and state invoices for allowability and coding , and maintain the grants compliance and reporting calendar. + ... eview and approv e of all federal and state invoices for allowability, correct coding , GAAP and Uniform Grant Guidance compliance , and complete support prior to… more
- Providence (Oakland, CA)
- …billing and coding practices; and providing education related to coding , medical record documentation requirements, healthcare compliance and fraud, waste ... Healthcare Fraud Investigator (AHFI) upon hire. + Certification as an Internal Auditor or Healthcare Compliance certification upon hire. + Clinical background.… more