- Elevance Health (Grand Prairie, TX)
- ** Clinical Provider Auditor II ** **Supports the Payment Integrity line of business** **Virtual:** This role enables associates to work virtually ... Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Provider Auditor II ** is responsible for… more
- LA Care Health Plan (Los Angeles, CA)
- …to achieve that purpose. Job Summary The Risk Adjustment Coding Auditor II position is responsible for auditing clinical documentation and coding to assess ... Risk Adjustment Coding Auditor II Job Category: Accounting/Finance Department:...public agency created by the state of California to provide health coverage to low-income Los Angeles County residents.… more
- Veterans Affairs, Veterans Health Administration (Montgomery, AL)
- …that categorizes all VA patients into specific classes representing their clinical conditions and resource needs. Monitors ever-changing regulatory and policy ... with the professional staff for clarification of conflicting or ambiguous clinical data. Expertly searches the patient record to find documentation justifying… more
- Veterans Affairs, Veterans Health Administration (North Charleston, SC)
- …utilizing the current edition of International Classification of Diseases (ICD) Clinical Modification (CM) and Procedure Coding System (PCS), Current Procedural ... that categorizes all VA patients into specific classes representing their clinical conditions and resource needs. Monitors ever-changing regulatory and policy… more
- Highmark Health (Harrisburg, PA)
- …coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure ... meetings and interacts with management to resolve issues and provide advice on new programs. Provides guidance to system...+ Validates the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems, missed secondary diagnoses and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and represents non- clinical staff in discussions with Medical Directors and/or clinical consultants. + Serves as an internal auditor /peer reviewer for new ... of the SIU Management, this position is responsible for the accurate and thorough clinical investigation of potential fraud, waste and abuse (FWA) for all lines of… more
- The County of Los Angeles (Los Angeles, CA)
- …in nearly every medical specialty and subspecialty. In addition, to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the ... solution of problems of organization, program, procedure, budget, or personnel. Option II : Two (2) years of highly responsible administrative or staff experience at… more
- The County of Los Angeles (Los Angeles, CA)
- …in nearly every medical specialty and subspecialty. In addition to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the ... program, procedure, budget, or personnel. - OR - Option II : Two (2) years of highly responsible administrative or...Assistant III**, Assistant Hospital Administrator I , Contract Program Auditor , or higher. YouMUSTmeet one of the above… more
- The County of Los Angeles (Los Angeles, CA)
- …in nearly every medical specialty and subspecialty. In addition to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the ... control systems. Supervises the review of audit findings prepared by the County Auditor and outside agencies and supervises the preparation of reports to support… more
- The County of Los Angeles (Los Angeles, CA)
- …of Intermediate Accountant- Auditor , Accountant III or higher. PHYSICAL CLASS II - Light: This class includes administrative and clerical positions requiring a ... in nearly every medical specialty and subspecialty. In addition to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the… more
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