The Coding Auditor demonstrates expertise in coding and billing compliance while performing audits to determine billing integrity of professional and facility/technical fees including detection and correction of documentation, coding and billing errors and/or medical necessity of services billed. Audits consist of evaluation of the adequacy and accuracy of documentation i

The Clinical Defense Auditor will collaborate clinically with the patient care team and third parties to determine appropriateness and medical necessity of emergency care, admissions and specialty referrals. Qualifications Minimum Education Bachelor's Degree RN, BSN preferred or extensive clinical experience in utilization management for healthcare. (Required) Minimum Wor

Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD 10 CM/PCS coding and/or CPT 4 procedure coding classification systems. II. Principal Responsibilities and Tasks The following st

Under direct supervision, the Auditing Team Lead provides day to day supervision and instruction of the auditors. The Auditing Team Lead oversees the internal and external auditing function and assist Director Inpatient Coding, Coding Audits, and Education in developing reports specific to audit findings and assists with implementing action plans. The Auditing Team Lead e

Open Recruitment (REPOST) State Highway Administration Grade 20 (7166) SP# 24 17 04 Internal Audits Manager (DOT Internal Auditor Program Supervisor) YOU MUST APPLY ONLINE TO BE CONSIDERED FOR THIS POSITION Previous Applicants Need Not Reapply THE RECONSIDERATION PERIOD FOR THIS RECRUITMENT IS THREE (3) BUSINESS DAYS The State Highway Administration's (SHA) Office of Audi

Collaborate in the planning of internal audits by gathering specific relevant background information (such as financial results, and policies and procedures) from the Institutions information systems, web based and other information sources. Will conduct a complete analysis of assigned tasks and be able to make action recommendations. Contribute to the design of internal

Conducts independent reviews/audits on the adequacy of medical record documentation to support the codes selected by providers or by billing office coders. Verifies and corrects as necessary, the audit work completed by the Compliance Auditors or other Sr. Auditors/Trainers. Analyzes documentation or coding patterns by a provider, division or department that poses a compl

Contributes to the achievement of established department goals and objectives, and adheres to IA department policies, procedures, quality standards and safety standards. Complies with governmental and accreditation regulations. Embodies and demonstrates the Mission, Vision and Spirit Values of MedStar. Analyzes findings to identify root causes. Communicates ideas appropri

Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations. Participates in multidisciplinary quality and service improvement teams as appropriate. Participates in meetings serves on committees, and represents

Requisition # 625171 Location Johns Hopkins Health Plans, Hanover, MD 21076 Category Non Clinical Professional Schedule Day Shift Who you are As the Vendor Auditor for Johns Hopkins Health Plans ("JHHP"), your in depth knowledge of auditing, claims, and medical policy helps ensure that our vendors are performing to policy and regulations. Not only will you lead audits, yo

Under general supervision, ensures that compliance initiatives are met for all the University of Maryland Medical System (UMMS) Member Organizations. Reviews and analyzes claims data, medical records, and billing and payment information to determine if charges and reimbursement are supported according to federal and state program guidelines. Significant contributor in the

Audit Overview Did you know that EagleBank has been ranked 13th in the Washington Business Journal's 2023 Corporate Diversity Index for midsize companies? This is a clear reflection of our commitment to diversity and inclusion initiatives as well the Bank's consistent focus on fostering an exceptional workplace culture. We are a values driven organization putting Relation

The Internal Audit function is an independent, objective assurance and consulting activity designed to add value and improve an organization's operations. It helps an organization accomplish its objectives by bringing a systematic, disciplined approach to evaluate and improve the effectiveness of risk management, control, and governance processes. ESAB Internal Audit is s

The role of an IT Compliance Manager is pivotal in ensuring that our organization adheres to regulatory standards, mitigates risks, and maintains robust governance processes. As an integral part of our team, you will collaborate closely with IT Organization, internal audit staff and external service providers to drive excellence in technology, cybersecurity, and regulator

Develops department goals, objectives, policies, and procedures. Ensures compliance with business unit policies and procedures and governmental and accreditation regulations. Develops and recommends department operating budget and manages resources according to approved budget. Selects, trains, orients, and assigns department staff. Develops standards of performance, eval