- Stanford Health Care (Palo Alto, CA)
- …and edit appeals for clarity and accuracy prior to submission to ensure high- quality presentation. + Audit Response: Ensuring the medical record documentation ... America) **This is a Stanford Health Care job.** **A Brief Overview** Clinical Government Audit Analyst and Appeal Specialist II plays a critical role in the Revenue… more
- Olympus Corporation of the Americas (Center Valley, PA)
- …standards, data review and query management, and is accountable for quality study dataset release and consistency for submission data. This role is responsible ... the Sr. Clinical Data Manager is accountable for driving timely and high- quality data management deliverables supporting the Olympus portfolio. The Sr. Clinical Data… more
- Oatey (Cleveland, OH)
- **Why Oatey?** Since 1916, Oatey has provided reliable, high- quality products for the residential and commercial plumbing industries, with a commitment to delivering ... quality , building trust and improving lives. Today, Oatey operates...expense vouchers and maintains accurate records and control reports. Review applicable accounting reports and accounts payable register to… more
- GCI Communication Corp (Anchorage, AK)
- …matter expert review and finalization (eg, EEO reporting) + Package audit samples (personnel files, proof of approvals), ensure redactions as instructed. + Log ... Deliver high- quality operational and employee support services by maintaining...support to ensure seamless operations. + Provide P-card transaction coding and reconciliation support, contributing to accurate financial tracking… more
- The Cigna Group (Bloomfield, CT)
- … Analysts specializing in HHS Risk Adjustment medical record diagnostic coding and quality audit review for the Individual and Family Plan (IFP) segment, ... The Quality Review and Audit ...The Quality Review and Audit Senior Supervisor is...to facilitate operational effectiveness. + Participates in development and review of coding guidelines, policies, and procedures… more
- HCA Healthcare (Nashville, TN)
- …growth, we encourage you to apply for our Coding Quality Audit Reviewer opening. We promptly review all applications. Highly qualified candidates ... result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to... of patient data, to ensure minimal variation in coding practices and to improve the quality … more
- Elevance Health (Chicago, IL)
- …based DRG Coding / Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad knowledge of medical claims ... medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review...information to make audit determinations and generate audit findings letters. + Maintains accuracy and quality… more
- 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
- Magellan Health Services (Baton Rouge, LA)
- …other clinical staff. + Provides training, interpretation and support for QI Clinical Reviewer staff. + Audits and validates internal audit results and/or ... record documentation. + Conducts ongoing activities which monitor established quality of care standards in the participating provider network...a team member. Knowledge of ICD and DSM IV coding or most current edition. Ability to analyze specific… more
- City of New York (New York, NY)
- …with all statutory, regulatory, and contractual standards. The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with ... Administrative Associate, who will function as a Senior Case Reviewer : - Conduct legally mandated case reviews to comply...(Reynolds, Lovely H., MKB, Dajour, Davila, Brown, etc). Convert audit findings into reports that is presented to Family… more
