• Compliance Coding Auditor

    Sharp HealthCare (San Diego, CA)
    …and employer business practices. **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) ... compliance audit program. The position provides oversight and maintenance of...+ Coding ComplianceCompliance Coding and Billing AuditsThe Compliance Coding Auditor has the primary responsibility of performing all audits… more
    Sharp HealthCare (07/13/25)
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  • Lead Auditor CRS

    UL, LLC (Allentown, PA)
    …one or more scope specific professional credential(s), such as: GFSI recognized auditor credential; CQA, RABQSA, IRCA, RAC , Pharmaceutical GMP Professional ... Lead Auditor - GMP Quality Audits will perform high...report in accordance with UL, industry scheme, and client audit protocols on facilities working and/or operational conditions as… more
    UL, LLC (07/03/25)
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  • Coding Auditor Educator

    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
    Highmark Health (07/16/25)
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  • Remote Inpatient Denials Auditor

    Amergis (San Antonio, TX)
    …$40 / Hour Inpatient Denials Auditor must have experience with the following: - RAC / RAM Denials - Claim Adjustment Denials - PSI / HAC Reviews - Stroke ... Accounts - Creating Appeal Letters - Focused DRG Reviews for missed CC or MCC Comfortable with Re-Coding accounts and providing feedback to original coders EPIC & Optum CAC experience (REQUIRED) AHIMA REQUIRED Benefits At Amergis, we firmly believe that our… more
    Amergis (07/12/25)
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  • RN Clinical Review Appeals Specialist

    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 (07/08/25)
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  • Auditing & Compliance Director - Software as…

    Wolters Kluwer (Chicago, IL)
    …and recommending comprehensive upgrades to prevent future issues . Lead Auditor Certified, preferred . Regulatory Affairs Certification ( RAC ), preferred. ... Kluwer. Important responsibilities include cross-functional correspondence, quality management reviews, audit support, change planning, and corrective and preventative action… more
    Wolters Kluwer (06/11/25)
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  • Senior Manager, Verification Programs

    The US Pharmacopeial Convention (USP) (Rockville, MD)
    …to cGMP requirements and proficiency with regulation and guideline interpretation, audit procedures, proper documentation, and quality assurance. * Experience with ... Certification from the American Society for Quality (ASQ) as a Certified Quality Auditor (CQA) and/or from the Regulatory Affairs Professional Society (RAPS) as a… more
    The US Pharmacopeial Convention (USP) (04/30/25)
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