- UPMC (Pittsburgh, PA)
- …required. + MBA, MA, and/or other advanced degree preferred. + 12+ years of audit (internal and/or external), quality assurance/ review , internal controls and ... Health Plan product lines. The role also leads the organization's Focused Review & Internal Controls; SOX/MAR (Model Audit Rule) testing/assurance; Technology… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …time and make recommendations for provider education content. + Perform consistent, standardized coding quality reviews on provider groups to ensure complete and ... written materials to support providers and their staff in coding and documentation initiatives. + Review necessary...duties. We're Looking for: + Working knowledge of RADV Reviewer guidance and AHA Coding Clinic +… more
- Covenant Health Inc. (Knoxville, TN)
- …11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we ... Summary: Performs complex level professional internal auditing work. Work involves compliance audit projects for Covenant Health entities as they relate to charging,… more
- Covenant Health Inc. (Knoxville, TN)
- …conducted by Revenue Integrity Department Auditors and Appeal Coordinators. Oversees audit and denials management workflow including quality and reporting. ... entities to lead and conduct revenue cycle and compliance audit projects as they relate to charging, coding...manager. + Works with contract management personnel in the review of contracts and other reimbursement or payment arrangements… more
- Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
- …reports performance monitors for PCE, VERA and Non-VA Medical Care (purchased care) coding . Audit accurate and complete assignment of ICD-10-CM, CPT, and HCPCS ... and coding requirements. Maintains current knowledge to ensure that coding and documentation meets regulatory guidelines and audit standards, and… more
- Veterans Affairs, Veterans Health Administration (Indianapolis, IN)
- …performance monitors for PTF, PCE, VERA and Non-VA Medical Care (purchased care) coding . Audit accurate and complete assignment of ICD-10-CM and ICD-10-PCS ... offices, group practices, multi-specialty clinics, and specialty centers. These coding practitioners analyze and abstract patients' health records and assign… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …manner. Perform random quality audits as schedule permits. + Work and review a high volume of accounts assigned to Revenue Integrity Specialist work queues for ... documentation to charge code injection and infusion charges, and review of various charge audit . + Ensure...Review and Analysis, and outside consultants to analyze, review and assess identified billing, coding , charging… more
- Veterans Affairs, Veterans Health Administration (Murfreesboro, TN)
- …Auditors perform audits of encounters to identify areas of non-compliance in coding . They facilitate improved overall quality , completeness, and accuracy of ... review assigned codes. They perform prospective and retrospective coding audits and use results to identify documentation, ...documentation, coding inadequacies, and re-educate clinical and coding staff based on audit results. They… more
- Excelsior Orthopaedics Group (Amherst, NY)
- …appropriate use of ICD-10-CM, CPT, and HCPCS codes. + Code Accuracy and Compliance: Review and audit ICD-10-CM, HCPCS, and CPT codes for surgical procedures, E&M ... patients, including inpatient and outpatient procedures. + Medical Record Audits: Audit medical records for accurate coding , ensuring proper documentation… more
- Billings Clinic (Billings, MT)
- …an action plan. Monitors all high dollar discharges to ensure high levels of coding quality . Presents recommendations for review and consideration by the ... , billing and reimbursement. * Maintains or exceeds 95% coding accuracy based on audit findings. *...assisting with problem resolution. Assists management team in maintaining high- quality coding functions by application and adherence… more
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