operations; medical terminology; ICD-10, RVS, and CPT coding knowledge; knowledge of Medicare and Medi-Cal guidelines; 10-key... SUMMARY The Claims Auditor assists in the Claims Department by analyzing procedures, policies and reports; ensures...
Risk Adjustment Auditor II Work a Hybrid schedule within Oregon, Idaho, Utah or Washington Build a career... in provider coding/documentation and works closely with Provider Education Consultants to develop intervention strategies...
candidate must have extensive clinical experience and an active coding certification with a background in auditing medical... corrective education and training. Reviews medical records to validate accurate diagnosis/procedure coding and compliance...
Job Category: Healthcare Quality Job Description: EXL Health, is seeking an experienced Clinical Validation Auditor... coding Responsible for reviewing the accuracy and consistency of clinical DRG auditing auditors to ensure audits...
), Certified Coding Specialist (CCS), or Certified Professional Medical Auditor (CPMA) Certified in Healthcare Compliance (CHC..., compassionate care for all. The Compliance Auditor supports Marin Community Clinics’ compliance, risk management, and quality...
Auditor who is responsible for performing DRG validation (clinical/coding) reviews of medical records...It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges...
candidate must have extensive clinical experience and an active coding certification with a background in auditing medical... corrective education and training. Reviews medical records to validate accurate diagnosis/procedure coding and compliance...
Auditor who is responsible for performing DRG validation (clinical/coding) reviews of medical records...It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges...
knowledge of clinical criteria to determine medical necessity, appropriateness of setting, potential billing/coding issues... but will need to obtain a coding certification within 6 months. 5 to 7+ years of working with a broad knowledge of medical claims...
and a passion for getting the details right? Join EXL as a Clinical Validation Auditor and help ensure medical claims are coded... accurately and fairly. This is a fully remote position where you'll use your clinical judgment to review medical records...
credentials of CPC, RN, or RHIT/RHIA/CCS. 3. Strong knowledge of medical terminology and ICD-10-CM/PCS coding guidelines. 4... and communities we serve. We are looking for a meticulous and analytical Payment Integrity Auditor to ensure accurate claims payment...
Quality Assurance Analyst (Insurance Auditor Focus) – Pittsburgh, PA 15219 (Downtown) Status: Full-Time Shift: Day.../Call-in Pay). Health & Wellness: Comprehensive Medical, Dental, Vision, and Prescription Drug Coverage, plus Flexible...
policies. This position plays a critical role in validating medical necessity, principal diagnosis selection, and CC/MCC coding... clients, the auditor leverages deep clinical and coding expertise to identify improper payments, ensure documentation...
Health (CH) Health Information Management (HIM) Educator/Auditor is responsible for providing Provider Coding education... that are provided. The Educator/Auditor will introduce new providers to the coding program requirements across CHS/Trinity and provide...
relevant work experience. Experience: Three years 'experience in a compliance, medical coding or auditing role.... What you will do: We are looking for a COMPLIANCE AUDITOR who can help shape our vision and support our mission. Here is what the position will look like. Assists...
. What will I be doing in this role? The Coding Auditor works under the general direction of the Coding Supervisor. A Coding Auditor.../procedures/handbook, American Hospital Association (AHA) and American Medical Association (AMA) coding references, local, State...
, and hospital billing including detection and correction of documentation, coding, and billing errors and/or medical necessity... and application of documentation and coding rules and regulations, and medical necessity of services delivered. This position sits...
effective appeal letters that include appropriate coding guidelines and medical references. Identifies trends in external audit... Documentation Denials Auditor to join the team. This role will be fully-time remote, Monday-Friday, regular business hours 8:00...
Medical Auditor) #LI-LS1 #LI-REMOTE Join an award-winning company Five-time winner of “Best in KLAS” 2020-2022, 2024... possible in healthcare. The Nurse Auditor I performs charge audits and other assessments as assigned by management. This role...
& RESPONSIBILITIES: The Clinical Auditor will review medical records to determine accuracy of billing through verification of coding... (clinical/coding) reviews of medical records and/or other documentation. This role will determine correct DRG/coding as defined...