- Community Health Systems (Franklin, TN)
- …admission (POA) indicators, discharge disposition, and any other relevant data to ensure coding accuracy. The auditor is also responsible for writing and ... **Job Summary** The DRG Denials Auditor conducts hospital inpatient DRG denial audits for...non-RAC accounts, reviewing patient records for accuracy in ICD-10-CM/PCS coding , DRG assignments, and supporting clinical documentation. This includes… more
- UPMC (Pittsburgh, PA)
- **Join UPMC Corporate Compliance as an Intermediate Compliance Auditor !** Are you passionate about ensuring accuracy and compliance in healthcare documentation and ... **UPMC Corporate Compliance** is seeking a dedicated and detail-oriented **Intermediate Compliance Auditor ** to join our team! This position will be based out of… more
- UPMC (Pittsburgh, PA)
- UPMC Health Plan has an exciting opportunity for a Risk Adjustment Clinical Auditor /Analyst position in the Medicare department. This is a full time position working ... daylight hours and will be fully remote.. The Clinical Auditor /Analyst is an integral part of the Risk Adjustment...are supported within the audit year, and utilize AHA Coding clinics, ICD-10-CM Coding Guidelines, CPT … more
- UPMC (Pittsburgh, PA)
- **Join UPMC Corporate Finance as a Compliance Auditor , Associate!** Are you detail-oriented and passionate about ensuring compliance in healthcare? **UPMC Corporate ... Finance** is looking for a dedicated and meticulous **Compliance Auditor , Associate** to join our team. This role is...role is crucial in maintaining the integrity of our coding and billing processes, ensuring they meet state and… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …with the Plans' provider agreements and the National Healthcare guidelines. The Professional Auditor helps improve clinical outcomes and quality of care, to ... Auditor will be a subject matter expert regarding coding and billing. The Professional Auditor , under...stakeholders informed of assessed levels of risk. Identifies potential quality of care issues and potential fraud, waste, or… more
- Capital One (Mclean, VA)
- Principal Auditor - Cyber, Risk and Analysis Technology Audit Capital One's Audit function is a dedicated group of professionals focused on delivering top- quality ... Capital One is seeking an energetic, self-motivated Principal Technology Auditor with experience evaluating and analyzing technology and cybersecurity risks… more
- Elevance Health (Mendota Heights, MN)
- **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually full-time, ... granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
- Veterans Affairs, Veterans Health Administration (IN)
- …26 Auditors perform audits of encounters to identify areas of non-compliance in coding . They facilitate improved overall quality , completeness, and accuracy of ... code selection. Reviews assigned codes from the current version of several coding systems to include current versions of the International Classification of Diseases… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Network Provider Services Auditor performs audits as part of the Documentation and Coding Compliance Program ... In doing so, works with providers and their office staff, as well as the Coding and SLPG Billing Department. JOB DUTIES AND RESPONSIBILITIES: + Perform quality … more
- Insight Global (South Jordan, UT)
- Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100% remote. This person should have an extensive background in ... either facility-based nursing, clinical documentation, and/or inpatient coding and has a high level of understanding of reimbursement guidelines specifically an… more