- YesCare Corp (Atmore, AL)
- …care and expertise. **Key Responsibilities** + **Administrative Duties:** + Chair the Medical Audit Committee, ensuring quality standards are upheld. + Consult ... with community medical providers to address and resolve patient care issues....Review and approve clinical protocols, policies, procedures, and the medical disaster plan annually. + Lead quality improvement initiatives,… more
- Insight Global (South Jordan, UT)
- …chart coding principles, clinical guidelines, and objectivity in the performance of medical audit activities. Draws on advanced ICD-10 coding expertise, clinical ... and APR-DRG payment systems. This position is responsible for auditing inpatient medical records and generating high-quality recoverable claims for the benefit of… more
- Elevance Health (Mason, OH)
- … chart coding principles, clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding expertise, ... (CDI, MS-DRG, AP-DRG and APR-DRG)** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs… more
- Cardinal Health (San Juan, PR)
- … medical terminology; E/M rules, teaching physician guidelines, and/or medical necessity defense reviews; healthcare compliance audit methodology, principles ... detection and correction of documentation, coding, and billing errors and/or medical necessity of services billed. Particular areas of focus include: evaluation… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …physician/researchers, and we work with amazing partners, including other Harvard Medical School-affiliated hospitals. + Oversee the audit , testing, and ... The Compliance, Audit & Investigations Senior Manager plays a vital...applicable federal and state regulatory requirements as well as medical practice compliance standards + Commitment and ability to:… more
- Trinity Health (Ypsilanti, MI)
- …and others to assure compliance. May be requested to assist with the medical record audit process. Documents patient phone calls and advice/treatment given ... supervision, prepares patients for office visit, takes vital signs and records in medical record, obtains patient chief complaint, escorts patient to exam room, and… more
- Justice, Bureau of Prisons/Federal Prison System (Pollock, LA)
- …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
- Molina Healthcare (Meridian, ID)
- …unrestricted in state of practice. + Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified ... for Quality Assurance (NCQA) guidelines, and other applicable requirements. + Distributes audit results letters, follow-up letters, audit tools and annual… more
- Point32Health (Canton, MA)
- …and contract interpretation in accordance to claims processing guidelines, Point32Health Medical and Payment Policies and established audit protocols. He/she ... we are at Point32Health (https://www.point32health.org/) . **Job Summary** The Sr Provider Audit Analyst is responsible for review of claims for accuracy of coding,… more
- Jupiter Rehabilitation and Healthcare Center (Jupiter, FL)
- …laws and in compliance with HIPAA (Health Insurance Portability Accountability Act). + Conduct audit of closed medical records using audit tool and submit ... Central Supply/ Medical Records PRINCIPLE FUNCTION: Performs activities associated with...5. Must have working knowledge of spreadsheet (Excel) programs Medical Records: + Prepares and maintains residents' records in… more