to identify cases for validation review. Conducts validation reviews/coordinates rates adjustments with appropriate claims area.... Creates monthly/quarterly reports to present to each line of business providing information on records review, outcomes...
our operations to meet the growing demand for quality medical auditing. This role offers an exciting opportunity to make.... A typical day involves conducting DRG reviews and audits, collaborating with the existing team of Medical Review Auditors...
software and documents findings to improve CC/MCC capture, Risk Variable capture, HAC/PSI, HCC and Quality Indicator validation... review and audit of discharged inpatient records (prebill and retrospective reviews) to validate the coding/DRG assignment...
for the controls as well as the control mapping to laws, regulations, and industry standards Perform quality review... Information Security Manager (CISM) or Certified Information Systems Auditor (CISA) or Certified Information Systems Security...
for the controls as well as the control mapping to laws, regulations, and industry standards Perform quality review... Information Security Manager (CISM) or Certified Information Systems Auditor (CISA) or Certified Information Systems Security...