- Houston Methodist (Katy, TX)
- …ethical and legal business practices and accreditation/regulatory/ government regulations. + ** Audit Oversight & Lifecycle Management** + Lead the management and ... response process for a variety of audits including RAC , MAC, CERT, PERM, TPE, and commercial payer audits....quality review, and timely submission. + Track and analyze audit trends, denials, and appeal outcomes to identify risks… more
- UL, LLC (Allentown, PA)
- …+ Assess and report in accordance with UL, industry scheme, and client audit protocols on facilities working and/or operational conditions as it relates to ... Nutritional Supplements: 21CFR111 + Medical/Homecare Devices: 21CFR820 + Cosmetics: ISO22716 + Complete audit agendas within 14 calendar days of the audit +… more
- Highmark Health (Harrisburg, PA)
- …entities in response to external coding audits conducted by the Medicare Administrative Contractor , the RAC , MIC, ZPIC, etc. Determine appeal action, prepare ... OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and… more
- Trinity Health (Langhorne, PA)
- …Maintains database of duplicate and overlay corrections for reporting purposes 11. Assists with RAC and other audit activity by entering needed data to track ... 4. Selects appropriate or defined sample size to support audit validity 5. As directed, performs audit ...support audit validity 5. As directed, performs audit of metadata to detect potential privacy breeches related… more
- St. Luke's University Health Network (Allentown, PA)
- …and procedure code assignment and MS-DRG/APR-DRG accuracy based on denials or audit findings from government and commercial payers. Meet or exceed established ... the physician advisor in review of patient medical records identified by RAC /MIC/QIO and other governmental or commercial payor auditors in retrospective reviews for… more
- Sharp HealthCare (San Diego, CA)
- …is responsible for the administration of the Sharp HealthCare's (SHC's) compliance audit program. The position provides oversight and maintenance of a high-quality, ... effective, best practices coding, billing, and reimbursement audit compliance program to prevent and detect violations of...risk analyzer software, OIG Work plan, CMS, PEPPER Reports, RAC Denials, industry experts, etc. + Policy and Procedure… more
- University of Pennsylvania (Philadelphia, PA)
- …templates). This individual communicates independently at all levels and ensures audit /inspection readiness of assigned projects. The Regulatory Affairs Specialist C ... templates). This individual communicates independently at all levels and ensures audit /inspection readiness of assigned projects. The Regulatory Affairs Specialist C… more
- University of Pennsylvania (Philadelphia, PA)
- …to senior leadership department-wide trial characteristics, accrual information and audit /monitoring findings; such reports will include an assessment of trial ... of clinical trial compliance and quality assurance through communication of audit results and compliance guidelines. + The Associate Director for Regulatory… more
- BD (Becton, Dickinson and Company) (San Diego, CA)
- …guidance and frameworks for software development in a healthcare IT environment. + ** Audit Oversight** : Oversee all internal and external audits, ensuring audit ... in Engineering, Life Sciences, Regulatory Affairs, or related field (Master's or RAC certification preferred). + 10+ years of progressive experience in Quality… more
- Abbott (Maple Grove, MN)
- …and sustaining teams. + Participate in and support audits and responses to audit findings as appropriate, in root cause analysis, preventive or corrective actions, ... Experience in structural heart / structural intervention devices + Certification is a plus (eg, RAC and PMP) + MD / PhD/RN/Pharm D with good written skills The base… more