- Humana (Corpus Christi, TX)
- … 1 consults and collaborates with clinicians to ensure high accountability of compliance and quality. The Quality Assurance, Clinical Professional 1 work ... often straightforward and of moderate complexity. The Quality Assurance, Clinical Professional 1 supports and implements programs to establish high quality standards… more
- Baystate Health (Springfield, MA)
- …of diversified duties in connection with reviews of medical record documentation for professional billing to ensure it meets the AMA and CMS (Medicare) guidelines ... at all levels. The incumbent has an understanding of compliance audit concepts. This includes but is not limited...billing. **2)** Validates and identifies appropriate ICD-9 (ICD-10) diagnosis coding as it pertains to specific risk adjustments and… more
- Bon Secours Mercy Health (Cincinnati, OH)
- … coding , and trending of non-compliant activities to enhance compliance proficiency and competency, understanding of standards and the consequences of ... and operational excellence. Job Description **Summary** Works collaboratively with the Compliance Manager on creating auditing protocols which align with Bon Secours… more
- Elevance Health (MD)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** **Location: Must be located in Maryland.** This field-based role enables ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more
- Elevance Health (Atlanta, GA)
- **Clinical Provider Auditor I (CPC)** **Hybrid 1:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, ... is granted as required by law.** The **Clinical Provider Auditor I (CPC)** is responsible for identifying issues and/or...you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies… more
- Elevance Health (Norfolk, VA)
- **Clinical Provider Auditor II** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and connectivity, ... is granted as required by law. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities...you will make an Impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies… more
- Methodist Health System (Dallas, TX)
- …of experience for auditing and abstracting. **_Preferred_** : Certified Professional Medical Auditor (CPMA) certification from AAPC **_Experience/Knowledge_** ... or equivalent; some college credit; Bachelor's degree preferred. Certified Professional Coder ( **CPC** ) certification from AAPC **or**...in training and education of coders and staff on compliance billing and coding principles for government… more
- CIBC (New York, NY)
- …As a member of CIBC's Internal Audit team, the Senior Auditor /Manager/Senior Manager is responsible for conducting risk-focused audits; advising business units ... the design, implementation, and maintenance of internal controls; and promoting compliance with CIBC policies and procedures, accounting standards, control policies,… more
- Veterans Affairs, Veterans Health Administration (Fayetteville, NC)
- …coded information for the full spectrum of services provided by the VAMC. Timely compliance with coding changes is crucial to the accuracy of the facility ... levels of staff to promote consistency in practice and compliance with coding rules and regulations; initiates...(Outpatient and Inpatient). Auditors serve as experts of current coding conventions and guidelines related to professional … more
- SSM Health (MO)
- …external customers, answering questions, researching topics and providing information regarding coding , documentation and compliance issues. + Partners with ... **Worker Type:** Regular **Job Highlights:** Exciting opportunity for an Corporate Responsibility Auditor Senior role SSM Health! Preferred RN background is a plus.… more