- Beth Israel Lahey Health (Charlestown, MA)
- …projects in which senior managers are involved. * Assist in the tracking and review of payer audit and denial results. Prepare appeal requests as appropriate. ... CPT/HCPCs/DRG coding experience required. * Clinical education and/or utilization review experience is strongly preferred. * Requires minimum 2 years of… more
- YMCA of Greater Seattle (Seattle, WA)
- …across multiple revenue systems. This role owns operational revenue controls and audit readiness for billing and collections, and partners with the Senior Director ... monthly spend-downs, validate federal and state invoices for allowability and coding , and maintain the grants compliance and reporting calendar. + Maintain… more
- Datavant (Augusta, ME)
- …and acting on undiagnosed conditions (prospective suspecting) and ensuring risk adjustment coding accuracy in near real-time (concurrent review ). You will manage ... regulations and best practices related to prospective risk capture and concurrent review . **Compliance & Quality :** + Partner with Legal, Compliance, and… more
- Insight Global (South Jordan, UT)
- … principles, clinical guidelines, and objectivity in the performance of medical audit activities. Draws on advanced ICD-10 coding expertise, clinical guidelines, ... background in either facility-based nursing, clinical documentation, and/or inpatient coding and has a high level of understanding of...management team. Achieves the expected level of accuracy and quality set by the audit for the… more
- Novant Health (Charlotte, NC)
- … coding audits, Health Information Management, Revenue Integrity, Charge Capture, Utilization Review and Provider coding support services. This leader will be ... leadership, and operations support for clinical work such as utilization review , coding , clinical documentation improvement, health information management,… more
- Elevance Health (Denver, CO)
- …letters. + Maintains accuracy and quality standards as established by audit management. + Identifies potential documentation and coding errors by recognizing ... the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. **How...clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding… more
- Community Health Systems (Franklin, TN)
- … coding experience required + 2-4 years Inpatient acute care hospital coding audit experience preferred + 1-2 years Clinical Documentation Improvement or ... provides audit feedback to relevant parties, including coders and coding managers, to improve coding practices and compliance. **Essential Functions**… more
- Beth Israel Lahey Health (Woburn, MA)
- …departments' adherence to professional charge reconciliation, work-queue, and professional coding quality expectations and support departments with education, ... HMFP Compliance Department. * Monitor, investigate, and report revenue integrity and coding quality concerns to appropriate stakeholders and provide any… more
- UPMC (Pittsburgh, PA)
- …and co-morbidities, and procedures are accurately coded and sequenced according to coding and compliance guidelines. + Review billing data when conducting ... profiles to identify total amount of optimization and missed opportunities. Meet with coding management as scheduled to review progress, discuss problems, and… more
- Option Care Health (Bannockburn, IL)
- …and implementing auditing and/or monitoring programs. Intermediate proficiency in analysis and audit techniques and documentation review , with the ability to be ... with other functional areas and field teams to coordinate audit and monitoring activities from initiation through completion of...key risk areas such as regulatory changes, billing and coding , privacy and security, and fraud and abuse. +… more