- Elevance Health (Louisville, KY)
- **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ _This role enables associates to work virtually full-time, with the exception of required in-person ... to recover, eliminate and prevent unnecessary medical-expense spending. The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records… more
- Highmark Health (Frankfort, KY)
- …OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality ... and accuracy of coding , billing and documentation related to DRGs, APCs, CPTs...Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician… more
- Humana (Frankfort, KY)
- …years of healthcare experience in revenue cycle management (related to billing, coding , collections for Medicare and Medicaid claims) + Experience with Auditing and ... monitoring of healthcare records + Must be able to work core business hours on EST time between (9am-5pm). + Willingness to travel up to 10% to conduct audits at site locations. + Ability to manage multiple or competing priorities and meet deadlines + Must be… more
- Humana (Frankfort, KY)
- …This is a full-time, remote/work-from-home position. **Description** The Inpatient Medical Coding Auditor extracts clinical information from medical records and ... Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper reimbursement,… more
- Elevance Health (Louisville, KY)
- **Diagnosis Related Group Clinical Validation Auditor -RN** **Virtual:** This role enables associates to work virtually full-time, with the exception of required ... Friday 8AM -5PM (local time) The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
- Datavant (Frankfort, KY)
- …for healthcare. **What We're Looking For:** As an HCC (Hierarchical Condition Category) Auditor you will review medical records that have been coded in a ... a diagnosis level + Answer rebuttals entered on the auditor by coders and or auditors + Participate in...by coders and or auditors + Participate in weekly coding project review meetings + Any other tasks asked… more
- Molina Healthcare (Louisville, KY)
- …payment in all markets * Performs monthly audit on internal Molina Coding Specialists * Audits external Molina Vendors. **Job Qualifications** **Required Education** ... Associates degree. **Required Experience** 3 Years in coding and medical record chart review and experience with risk adjustment data validation Required Li… more
- Molina Healthcare (Bowling Green, KY)
- …conducting various audits including, but not limited to; vendor, focal, audit the auditor . Confirm that documentation is clear and concise to ensure accuracy in ... specific policies and regulations in order to identify incorrect coding , abuse and fraudulent billing practices, waste, overpayments, and...& ABILIITIES:** + Minimum 2 years as an operational auditor for at least one core operations function +… more