- Houston Methodist (Houston, TX)
- …revenue opportunities. This position performs quality assurance, detailed claims analysis and medical record reviews of complex claims and records and serves as a ... documentation and billing practices as well as potential risk areas with electronic medical record. + Provides periodic status reports of risk-based audit … more
- Henry Ford Health System (Troy, MI)
- …and to identify opportunities for fraud and abuse prevention and control. + Performs medical record audits including audit of claims, rate tables, fee screens, ... audits or medical record audits. + Minimum three (3) years of claim audit , medical record audit or professional audit experience. + Minimum five (5)… more
- City of New York (New York, NY)
- …who will ensure that youth in ACS care and/or custody receive the best possible medical care. In doing so, the Audit Nurse will work closely with operations ... Division by ensuring that our youth receive comprehensive and consistent medical , mental health, case management, and social services throughout their involvement… more
- Molina Healthcare (Oakland, CA)
- …Certification, Association** + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialists (CMAS) + Certified Case Manager (CCM) + ... federal, NCQA, and any other applicable requirements. + Distributes audit results letters, follow up letters, audit ...Distributes audit results letters, follow up letters, audit tools, and annual reporting requirement as needed. +… more
- Point32Health (Canton, MA)
- …and contract interpretation in accordance to claims processing guidelines, Point32Health Medical and Payment Policies and established audit protocols. He/she ... to our members, partners, colleagues and communities. **Job Summary** The Sr Provider Audit Analyst is responsible for review of claims for accuracy of coding,… more
- Justice, Bureau of Prisons/Federal Prison System (Los Angeles, CA)
- …Bureau of Prisons (BOP) and medical staff requirements. Performs the monthly medical record audit in coordination with the medical staff. Processes ... individuals for successful reentry into our communities. Responsibilities Analyzes medical records for completeness, consistency and compliance with Joint Commission… more
- Justice, Bureau of Prisons/Federal Prison System (Manchester, KY)
- …Bureau of Prisons (BOP) and medical staff requirements. Performs the monthly medical record audit in coordination with the medical staff. Processes ... individuals for successful reentry into our communities. Responsibilities Analyzes medical records for completeness, consistency and compliance with Joint Commission… more
- University of Washington (Seattle, WA)
- …are escalated appropriately. + Brief senior leadership (eg, Senior Director, Chief Medical Officers) on audit results, regulatory shifts, and mitigation plans ... Medicine's system-wide leader for credentialing compliance, regulatory oversight, and internal audit strategy. This role is essential to protecting the institution's… more
- Danaher Corporation (Sunnyvale, CA)
- …(IVDR) as well as other applicable global regulatory requirements, including Medical Device Single Audit Program (MDSAP) participating regulatory authorities ... the Cepheid QMS to identify and implement improvements and ensuring that all internal audit findings are closed in a timely manner with effective corrective action .… more
- Scripps Health (San Diego, CA)
- …Certified Internal Auditor from Association of Healthcare Internal Auditors (AHIA), or Certified Medical Audit Specialist by American Association of Medical ... division. * Experience required with reimbursement methodologies, auditing of medical records to support billed services, appealing denied services, evaluating… more