- CVS Health (Albany, NY)
- …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 (Albany, NY)
- …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 (Albany, NY)
- …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 (Albany, NY)
- 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
- Mount Sinai Health System (New York, NY)
- …and related professions). ? Certifications such as Certified Professional Medical Auditor (CPMA), Certified Inpatient Coder (CIC), Certified Coding Specialist ... **Job Description** **Clinical Revenue Auditor -CDM Patient Financial Services-Corporate-Full-Time-Days-Option to work remote or hybrid.** The Clinical Revenue … more
- Intermountain Health (Albany, NY)
- **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
- Excellus BlueCross BlueShield (Rochester, NY)
- …contracts, group benefit structures, Corporate Medical Policies, the AMA CPT Coding Guidelines, HCPCS coding , inter-plan regulations, government policies, as ... a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned,… more
- Coinbase (Albany, NY)
- …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
- Albany Medical Center (Albany, NY)
- …Under the direction of the Director of Pharmacy the Pharmacy Revenue Integrity Auditor will serve as a pharmacy liaison and interface with finance, billing, revenue ... decisions + Develop policies, guidelines, and procedures for pharmaceutical coding , billing, pricing, charging, and denial management to maximize reimbursement… more