- CVS Health (Boston, MA)
- …regulations and internal policies and procedures. + Proven ability to support coding judgment and decisions using industry standard evidence and tools. + Proficient ... providers in the office and/or facility setting. + Sound knowledge of coding guidelines and regulations to meet compliance requirements, such as establishing medical… more
- Humana (Boston, MA)
- …of our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and ... (eg, ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex...to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where… more
- Highmark Health (Boston, MA)
- …and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding , billing and documentation ... and disease processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and assistance from management,… more
- Datavant (Boston, MA)
- Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data ... platform is powered by the largest, most diverse health data network in the US, enabling data ...to realize our bold vision for healthcare. As an Auditor , HCC Risk Adjustment Coder, you will review medical… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …with the Plans' provider agreements and the National Healthcare guidelines. The Professional Auditor helps improve clinical outcomes and quality of care, to ... Auditor will be a subject matter expert regarding coding and billing. The Professional Auditor , under...stakeholders informed of assessed levels of risk. Identifies potential quality of care issues and potential fraud, waste, or… more
- Intermountain Health (Boston, MA)
- **Job Description:** The goal of the Clinical Documentation Specialist- Auditor is to improve the accuracy of the overall clinical picture and the representation of ... illness of patients through improved clinical documentation and diagnostic coding practices. Job Essentials Reviews medical records documentation for reimbursement,… more
- Baystate Health (Springfield, MA)
- …more accurate billing. **2)** Validates and identifies appropriate ICD-9 (ICD-10) diagnosis coding as it pertains to specific risk adjustments and correct coding ... Assists in preparing administrative reports, statements, roster, etc. Performs data and/or information gathering, creates spreadsheets, drafts and prepares special… more
- Astellas Pharma (Westborough, MA)
- …Organization (CMO) oversight and compliance considerations. + ASQ certifications (eg, certified quality engineer, quality auditor , quality professional, ... **Validation Lead, Quality Assurance** Do you want to be part...assessments and adhere to change management policies. + Ensure data integrity requirements are incorporated in facilities/utilities, equipment, automated… more
- Coinbase (Boston, MA)
- …importance of controls, an effective control environment, and the role of Internal Auditor . * Promote new ideas / innovative means of executing projects and internal ... * Solid analytical and problem solving skills, with high standards for quality , accuracy and attention to detail. * Excellent written and verbal communication… more