candidate must have extensive clinical experience and an active coding certification with a background in auditing medical... DRG coding or auditing experience with expert knowledge of ICD-10 Official Coding Guidelines and DRG reimbursement...
in Medical, Dental, or Pharmacy claims analysis. Experience in Healthcare Auditing, including Reviewing and Validating the... such as CMS Regulations and Coding Guidelines to Healthcare Claims Data. Recovery audit experience is preferred...
services. As a Medical Coder, you will provide coding and coding auditing services directly to providers. You'll play a key... ensuring a member-centric approach to care. Responsible for ensuring the accuracy and completeness of clinical coding...
forecasting, budget download and management, subcontractor invoicing, change orders, compliance auditing, and financial reporting... budget download process, and works with the PM / Super to set up the coding structure for the project. On a timely basis...
with all data collections and auditing activities. Accountable for completion of the Annual Standing Order Review and Internal... Classification of Disease (ICD) coding. Manages clinic financials including efficient utilization of supplies or equipment...
Finance Director; has contact with all city department heads, outside accounting and auditing personnel and the general public... in a variety of duties that include the following: Review invoices for accuracy, coding, purchase order requirements and data entry...
operations of CommunityCare’s medical claim review program. The Supervisor guides individuals in implementing auditing... and evaluating MRE goals. It also includes monitoring workload, staff supervision, training, coaching, auditing, teambuilding...
cycle compliance, coding, auditing, or related roles. Minimum of three (3) years of experience in a leadership or advisory.... Identify key compliance risks in coding, billing, documentation integrity, charge capture, medical necessity, and reimbursement...
call quality, auditing CRM and dialer activity, analyzing sales performance data, and preparing recurring reports... accurate result coding, proper documentation, and compliance with established workflow standards. Analyze call quality...
). Provide analysis and reporting of AI quality and business value, as well as auditing (e.g., bias, prompt injection, guardrails... the design and delivery of complex systems. Strong coding and system design skills in Python, and or Java...
), information systems risk management, information systems auditing, or a combination At least 1 year of experience in analyzing... data extracts to identify trends, patterns, and anomalies, including experience in testing scripting or coding (writing...
, creation of Desk Top References, compliance auditing, education, and quality event review. To accomplish these deliverables... system focused on events that generate high dollar claims. Identify and escalate discrepancies in payment rates, coding...
, creation of Desk Top References, compliance auditing, education, and quality event review. To accomplish these deliverables... system focused on events that generate high dollar claims. Identify and escalate discrepancies in payment rates, coding...
, creation of Desk Top References, compliance auditing, education, and quality event review. To accomplish these deliverables... system focused on events that generate high dollar claims. Identify and escalate discrepancies in payment rates, coding...
, creation of Desk Top References, compliance auditing, education, and quality event review. To accomplish these deliverables... system focused on events that generate high dollar claims. Identify and escalate discrepancies in payment rates, coding...
, creation of Desk Top References, compliance auditing, education, and quality event review. To accomplish these deliverables... system focused on events that generate high dollar claims. Identify and escalate discrepancies in payment rates, coding...
in overseeing key financial operations related to payment processing, invoice auditing, vendor portal administration, 1099..., and compliance with company policies Invoice Audit: Lead invoice validation efforts to ensure proper coding, approvals...
, creation of Desk Top References, compliance auditing, education, and quality event review. To accomplish these deliverables... system focused on events that generate high dollar claims. Identify and escalate discrepancies in payment rates, coding...
regulatory requirements. Responsibilities include Care Center specific coding, auditing, record maintenance, health record..., and completeness of health records and coding practices, with a particular emphasis on compliance with AHIMA, HIPAA, and state...
with all data collections and auditing activities. Accountable for completion of the Annual Standing Order Review and Internal... Classification of Disease (ICD) coding. Manages clinic financials including efficient utilization of supplies or equipment...