• Coding Quality Audit…

    HCA Healthcare (Orange Park, FL)
    **Description** **Introduction** Do you want to join an organization that invests in you as a Coding Quality Audit Reviewer ? At Parallon, you come first. ... make a difference. We are looking for a dedicated Coding Quality Audit Reviewer...result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to… more
    HCA Healthcare (09/27/25)
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  • Divisional Coding Quality Auditor…

    AdventHealth (Altamonte Springs, FL)
    …AHA Coding Clinic, CMS guidelines, NCCI guidance, etc. + Provides outcomes of coding quality audit reviews with leadership + Maintains current knowledge ... as supporting on-going quality assurance needs for coding staff. They will review medical records...and/or outpatient coding policies, procedures, and established audit schedule; translates quality auditing results into… more
    AdventHealth (09/17/25)
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  • Quality Auditor & Educator

    AdventHealth (Daytona Beach, FL)
    …AHA Coding Clinic, CMS guidelines, NCCI guidance, etc. Provides outcomes of coding quality audit reviews with leadership Maintains current knowledge of ... as supporting on-going quality assurance needs for coding staff. They will review medical records...and/or outpatient coding policies, procedures, and established audit schedule; translates quality auditing results into… more
    AdventHealth (08/07/25)
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  • DRG Coding Auditor

    Elevance Health (Chicago, IL)
    …based DRG Coding / Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad knowledge of medical claims ... medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review...information to make audit determinations and generate audit findings letters. + Maintains accuracy and quality… more
    Elevance Health (10/03/25)
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  • Inpatient DRG Reviewer

    Zelis (FL)
    …interests that shape who you are. Position Overview The Inpatient DRG Reviewer will be primarily responsible for conducting post-service, pre-payment and post pay ... comprehensive inpatient DRG reviews based on industry standard inpatient coding guidelines and rules, evidence based clinical criteria plan, and policy exclusions.… more
    Zelis (09/27/25)
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  • Senior Case Reviewer

    City of New York (New York, NY)
    …THE PRINCIPAL ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE. The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with ... Administrative Associate, who will function as a Senior Case Reviewer who will: - Conduct legally mandated case reviews...(Reynolds, Lovely H., MKB, Dajour, Davila, Brown, etc). Convert audit findings into reports that is presented to Family… more
    City of New York (08/09/25)
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  • NCA Pert Case Reviewer

    City of New York (New York, NY)
    …all statutory, regulatory and contractual standards. Within AO, is the Office of Quality Assurance & Fiscal Integrity conducts complex internal audits and quality ... identify areas of programmatic deficiencies. Within that area is the Process Evaluation Review Team (PERT). The unit analyzes error trends and determines the need… more
    City of New York (08/13/25)
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  • Inpatient DRG Sr. Reviewer

    Zelis (NJ)
    …responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG Quality Assurance reviews in an effort to increase the savings achieved ... as they compare with medical records utilizing ICD-10 Official Coding Guidelines, AHA Coding Clinic evidence based...What you'll do: + Perform comprehensive inpatient DRG validation Quality Assurance reviews to determine accuracy of the DRG… more
    Zelis (10/03/25)
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  • CA Pert Senior Case Reviewer

    City of New York (New York, NY)
    …IN THE PRINCIPLE ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE. The Office of Quality Assurance & Fiscal Integrity ensures the integrity, efficiency, and regulatory ... legal and federal, state and city regulatory requirements. The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with… more
    City of New York (08/13/25)
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  • Certified Risk Adjustment Coding…

    Redeemer Health Home Care & Hospice (Huntingdon Valley, PA)
    …journey. We invite you to apply today. SUMMARY OF JOB The Certified Risk Adjustment Coding / Audit Reviewer is a physician facing position and must have ... of diagnosis coding on risk adjustment payment models. Understand the audit process for risk adjustment models. Ability to identify and communicate documentation… more
    Redeemer Health Home Care & Hospice (08/13/25)
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