• Aequor (Thousand Oaks, CA)
    …reports. Ensure vendor compliance with approved processes and training requirements. Oversee case quality of US ICSRs (CT and PM) including analysis and reporting of ... trends in quality measures. Point of accountability for managing one or...assigned business partners. Case processing point of contact for audit related activities related to case processing. Accountable for… more
    HireLifeScience (09/25/25)
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  • Coding Quality Audit

    HCA Healthcare (Orange Park, FL)
    **Description** **Introduction** Do you want to join an organization that invests in you as a Coding Quality Audit Reviewer ? At Parallon, you come first. ... make a difference. We are looking for a dedicated Coding Quality Audit Reviewer...result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to… more
    HCA Healthcare (09/27/25)
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  • Divisional Coding Quality Auditor…

    AdventHealth (Altamonte Springs, FL)
    …AHA Coding Clinic, CMS guidelines, NCCI guidance, etc. + Provides outcomes of coding quality audit reviews with leadership + Maintains current knowledge ... as supporting on-going quality assurance needs for coding staff. They will review medical records...and/or outpatient coding policies, procedures, and established audit schedule; translates quality auditing results into… more
    AdventHealth (09/17/25)
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  • Quality Auditor & Educator

    AdventHealth (Daytona Beach, FL)
    …AHA Coding Clinic, CMS guidelines, NCCI guidance, etc. Provides outcomes of coding quality audit reviews with leadership Maintains current knowledge of ... as supporting on-going quality assurance needs for coding staff. They will review medical records...and/or outpatient coding policies, procedures, and established audit schedule; translates quality auditing results into… more
    AdventHealth (08/07/25)
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  • Inpatient DRG Reviewer

    Zelis (FL)
    …interests that shape who you are. Position Overview The Inpatient DRG Reviewer will be primarily responsible for conducting post-service, pre-payment and post pay ... comprehensive inpatient DRG reviews based on industry standard inpatient coding guidelines and rules, evidence based clinical criteria plan, and policy exclusions.… more
    Zelis (09/27/25)
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  • Senior Case Reviewer

    City of New York (New York, NY)
    …THE PRINCIPAL ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE. The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with ... Administrative Associate, who will function as a Senior Case Reviewer who will: - Conduct legally mandated case reviews...(Reynolds, Lovely H., MKB, Dajour, Davila, Brown, etc). Convert audit findings into reports that is presented to Family… more
    City of New York (08/09/25)
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  • NCA Pert Case Reviewer

    City of New York (New York, NY)
    …all statutory, regulatory and contractual standards. Within AO, is the Office of Quality Assurance & Fiscal Integrity conducts complex internal audits and quality ... identify areas of programmatic deficiencies. Within that area is the Process Evaluation Review Team (PERT). The unit analyzes error trends and determines the need… more
    City of New York (08/13/25)
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  • CA Pert Senior Case Reviewer

    City of New York (New York, NY)
    …IN THE PRINCIPLE ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE. The Office of Quality Assurance & Fiscal Integrity ensures the integrity, efficiency, and regulatory ... legal and federal, state and city regulatory requirements. The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with… more
    City of New York (08/13/25)
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  • Certified Risk Adjustment Coding

    Redeemer Health Home Care & Hospice (Huntingdon Valley, PA)
    …journey. We invite you to apply today. SUMMARY OF JOB The Certified Risk Adjustment Coding / Audit Reviewer is a physician facing position and must have ... of diagnosis coding on risk adjustment payment models. Understand the audit process for risk adjustment models. Ability to identify and communicate documentation… more
    Redeemer Health Home Care & Hospice (08/13/25)
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  • Coding Audit & Education Coordinator

    St. Luke's University Health Network (Allentown, PA)
    …be responsible for performing internal, concurrent, prospective and retrospective coding audit activities. The incumbent will also review and validate coded ... medical records of the Professional Coding (PC) staff to determine data quality ...one-on-one education sessions for PCs needing focused attention on audit findings. In addition, works in conjunction with network… more
    St. Luke's University Health Network (08/20/25)
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