, coding standards, and regulatory requirements. The Manager oversees operational QA testing, examiner-level audit programs... across the entire operational claims lifecycle including claim intake, data entry, adjudication, pricing, coding accuracy...
development lifecycle (SDLC), including design, coding, testing, and deployment. Conduct security reviews of application... assessments, penetration tests, and SOC 2 / ISO 27001 reports. Define and enforce secure coding standards and practices...
and professional services Key Responsibilities Process high-volume accounts payable transactions, including invoice review, coding... audits by providing documentation and responding to auditor requests. Collaborate with internal departments...
Auditor (CPMA) required 5+ years clinical experience or 5+ years medical record coding experience preferred Working... in our mission Reviews provider appeals and redeterminations using approved clinical and coding guidelines and documents appeal...
Auditor (CPMA) required 5+ years clinical experience or 5+ years medical record coding experience preferred Working... in our mission Reviews provider appeals and redeterminations using approved clinical and coding guidelines and documents appeal...
of all RCM processes related to specialty service lines, including but not limited to change capture, coding, billing..., and reimbursement outcomes. Oversee coding auditing and education related to specialty-specific documentation, coding accuracy...
with conducting software certification (SOI) reviews from the certification authority/auditor perspective. · Proficiency...’ experience in a software engineering role, including requirements, design, coding, and testing per RTCA DO-178B/C...
with conducting software certification (SOI) reviews from the certification authority/auditor perspective. · Proficiency...’ experience in a software engineering role, including requirements, design, coding, and testing per RTCA DO-178B/C...
Summary The Lead Auditor will be responsible for planning, supervising and conducting complex audits and special..., revenue cycle, research, grants and contracts, and education processes. The Lead Auditor will have the opportunity to lead...
required. Certified Professional Medical Auditor (CPMA) preferred. Experience Minimum 5 years of experience in coding... & Coder Education. This role ensures coding accuracy, compliance with regulatory guidelines, and optimal reimbursement through...
individual education needs of Clinical Documentation Specialists and collaborates with CDI Manager, IP Coding Manager, and IP... Coding Validation Manager to develop appropriate training materials. The primary goal of ensuring the documentation in the...
plus $5.09 for Health and Wellness Role Summary Responsible for accurate, timely facility inpatient coding and data validation... Perform facility inpatient coding including ICD-10-CM, ICD-10-PCS, DRGs, and HCPCS as assigned. Review full medical record...
including evolving guidelines, government policy, and College policy. Responsible for performing daily documentation and coding... and individual faculty members. Analyzes chart documentation to perform compliance, billing and coding audits to ensure compliance...
information from within internal · or other departments Responsible to send AEOS RQs to Coding as needed for clarification... for adjustment Notify management team of accounts that denied due to lack of medical necessity, etc, to be assigned nurse auditor...
policy. Responsible for performing daily documentation and coding audits to ensure correct compliance billing requirements... to perform compliance, billing and coding audits to ensure compliance and accuracy standards are being met. Performs record...
Title Healthcare Compliance Analyst **HYBRID - ONSITE IN KALAMAZOO, MI/REMOTE** The Compliance Auditor oversees the... of education and experience and 2-3 years of extensive coding experience required Clinic background preferred Certification...
and Coding - CMS - Medical Records coding and reports Education: Bachelor's degree in healthcare administration, business... Information & Management Systems (CPHIMS), Certified Professional Medical Auditor (CPMA), or certifications related to specific...
Experience: Seven years of experience with coding, risk adjustment models (Medicare Advantage) and leadership. Essential... Credentials: CRC (Certified Risk Adjustment Coder), CPMA (Certified Professional Medical Auditor), CDEO (Certified...
to audience. Effectively communicate information, issues and audit progress to teammates, clients and auditor-in-charge... you a better auditor. This will require leveraging the power of data analytics and furthering your technical expertise. You're a teacher...
must illustrate the amount of actual medical coding work performed. Additionally, resume must indicate the minimum amount of education... Quality, Group Practice Managers, or other MTF business functions in compiling, analyzing, and reporting MTF coding data...