- 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 ... 21CFR111 + Medical/Homecare Devices: 21CFR820 + Cosmetics: ISO22716 #MB-1 #LI-Remote Complete audit agendas within 14 calendar days of the audit Complete… 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
- 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
- St. Luke's University Health Network (Allentown, PA)
- …leadership team. Oversees account changes pertaining to accepted and/or appealed audit recommendations and works with staff assisting with clerical and ... administrative tasks related the appeals/ audit function. Identify and provide feedback, including identification of...advisor in review of patient medical records identified by RAC /MIC/QIO and other insurers or outside auditors in retrospective… more
- Actalent (Irvine, CA)
- …procedures to identify gaps, overlaps, and alignment opportunities for integration and audit readiness. + Migrate documents into systems like Propel and SharePoint, ... or equivalent discipline is required. Additional Skills & Qualifications + RAC Certification is preferred. + Experience with post-market and change management… more
- St. John's Embrace Living (Rochester, NY)
- …payer audits. This includes but is not limited to Department of Health Survey, PRI Audit , OMIG Audits, Third Party/HMO Audits, RAC and MAC reviews + Assure all ... guidance regarding the delivery of liability notices is maintained. Update process and educate staff when process is changed + Assist medical records coding of ICD-10 codes + Submit PBJ data through QIES + Provide education to the interdisciplinary staff… more
- Catholic Health Initiatives (Bismarck, ND)
- …are being adhered to within the department. Responsible for oversight of the clinic RAC audit releases and requests. + Maintains a cooperative relationship among ... health care teams by communicating information; responding to requests; building rapport; participating in team problem-solving methods. **Qualifications** **Education:** Associates Degree in Health Information Management or a related business degree and… more
- Mohawk Valley Health System (Utica, NY)
- …+ Provide peer-to-peer payor review in collaboration with attending physicians. + Support Recovery Audit Contractors ( RAC 's). + Assist with mitigating ... barriers to discharge and care progression. + Perform concurrent review of cases greater than 4 days or the assigned/estimated GMLOS + Partner with the care management team with the management of LOS, complex care needs and patient throughput efforts. Provide… more
- Mohawk Valley Health System (Utica, NY)
- …procedure codes, for accurate and timely billing of most appropriate payer + Audit charges and establish proper coding in collaboration with providers + Initiate and ... departments with diagnostic and procedural coding + Respond to Insurance, compliance and RAC denials + Review and assist in the maintenance of coding related… more
- LifePoint Health (Denver, CO)
- …coders, and working on various projects that involve coding and education including RAC audits. You would be working in a team environment with guidance from ... coding/auditing Pro-Fee experience required * Minimum 3 years experience in coding audit or quality review work required * CPMA certification within one year… more