. Responsibilities: As a Premium Auditor, you’ll play a critical role in ensuring accurate premium calculations and compliance... as needed Respond to inquiries from agents, customers, and underwriters professionally and accurately Verify claims coding accuracy...
and a passion for getting the details right? Join EXL as a Clinical Validation Auditor and help ensure medical claims are coded... and coding knowledge to spot inaccuracies and identify potential overpayments. Document your findings in clear, professional...
and mentoring the auditor and providing documented and validated findings. Encourage critical thinking and discussion among team... Types to include SNF, IRF, and HH. Train Clinicians with coding certifications on coding principles. Confer...
Job Category: Administration Job Description: Lead Compliance Auditor - Heavy Anesthesia & Healthcare Expertise... impact? FlexStaff is seeking a dynamic, detail-oriented Lead Compliance Auditor to join our client's team and lead the charge...
Quality Assurance Analyst (Insurance Auditor Focus) – Pittsburgh, PA 15219 (Downtown) Status: Full-Time Shift: Day... Risk Integrity department in Pittsburgh, PA. This role functions as a critical Insurance Auditor Analyst, primarily...
clients, the auditor leverages deep clinical and coding expertise to identify improper payments, ensure documentation...Purpose The DRG Auditor Clinical Appeals is responsible for conducting comprehensive retrospective reviews...
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...
patient status placement, accurate coding, and defensible payer billing. Focuses on clinical denials, observation services..., Coding, Medical Officer, and Physician Advisors to reduce clinical denials, improve documentation quality, and ensure...
patient status placement, accurate coding, and defensible payer billing. Focuses on clinical denials, observation services..., Coding, Medical Officer, and Physician Advisors to reduce clinical denials, improve documentation quality, and ensure...
Responsibilities Analyzes and Audits Claims. Integrates medical chart coding principles, clinical guidelines... and objectivity in performance of medical audit activities. Draws on advanced ICD-10 coding expertise, clinical guidelines...
coding. 6. Knowledge of CMS, third party payer and Joint Commission regulations, quality improvement processes...
schedules, coding guidelines, healthcare regulations and medical compliance. Monitors billing for trends. Communicates... designations such as coding certifications from AHIMA/AAPC/CMAS. Maintains strong written and verbal communication and negotiation...
schedules, coding guidelines, healthcare regulations and medical compliance. Monitors billing for trends. Communicates... designations such as coding certifications from AHIMA/AAPC/CMAS. Maintains strong written and verbal communication and negotiation...
billing schedules and policies, as well as Current Procedural Terminology (CPTs) and Healthcare Common Procedural Coding...
Familiar with Medi0Cal and/or managed care claims processing. Knowledge of CPT, HCPC procedure coding, and ICD -9/ICD10... diagnostic coding. Typing speed 30 wpm and proficient use of 10-key calculator. Familiar with AMISYS or similar claims systems...
diploma or GED required. Alabama nursing license (RN or LPN) preferred. Prior clinical or coding experience... Accounting, Chargemaster, coding, compliance or related field. Proficient in use of Microsoft Word and Microsoft Excel. Able...
coding guidelines, clinical validation requirements, and audit expectations. Leveraging deep clinical knowledge, the CVA... and education related to inpatient DRG validation and coding accuracy. Review clinical DRG audit outcomes to assess consistency...
for the auditing of patient bills and medical record documentation to ensure accurate charging based on billing and coding... inpatient and outpatient coding and/or charge auditing experience required. Minimum of two years data analysis experience using...
POSITION PURPOSE Areas of emphasis will include inpatient and outpatient coding of provider charges as well... with coding questions. SITE(S) Kenosha Campus Urgent Care Physicians Billing Service MINIMUM EDUCATION REQUIRED High...