Lead a team focused on assigned audit tasks and assume a lead position on audits.
Plan audits and manage communication with management regarding audit scope and findings.
Update and improve current audit procedures and programs.
Jobgether uses an AI-powered matching process to ensure applications are reviewed quickly, objectively, and fairly. They connect candidates with partner companies for various roles.
Collaborates with clinical documentation team to review inpatient accounts.
Assesses DRG, PDx, secondary Dx, PCS, POA and all documentation components impacting quality metrics.
Continually assures coding practices remain compliant with coding guidelines and regulations.
Northwestern Medicine strives for a positive workplace for every patient interaction. They are a leader in the healthcare industry, offering competitive benefits such as tuition reimbursement, loan forgiveness, and 401(k) matching.
Develop, maintain, and execute complex inpatient coding audit processes.
Design and deliver clinical coding education and training programs.
Partner with staff to resolve audit findings and improve coding accuracy.
CRD Careers is a boutique recruitment agency specializing in Sales and HR placements. We connect growth-minded companies with high-impact professionals who drive real results. This company's approach is precise, people-first, and built for long-term success.
Design engaging training, lead coders through evolving standards, perform high level audits, and shape best practices across multiple specialties.
Conduct detailed audits to identify under coding, over coding, documentation gaps, and compliance risks.
Spot trends in documentation and coding performance and collaborate on workflow improvements.
Oregon Health & Science University values a diverse and culturally competent workforce. They are an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status.
Lead, coach, and develop a team of Ops Associates.
Oversee the design and implementation of payor builds or process improvements.
Work closely with the Managers to identify process breakdowns and implement solutions.
Grow Therapy aims to be the trusted partner for therapists growing their practice, and patients accessing high-quality care. They are a three-sided marketplace that empowers providers, augments insurance payors, and serves patients, and have empowered more than ten thousand therapists and hundreds of thousands of clients across the country.
Lead the development and execution of Care Access’s quality program across clinical, operational, and technology domains.
Build and maintain a risk-based, fit-for-purpose Quality Management System (QMS) that supports Care Access’s mission.
Collaborate with Operational Compliance, Product, Privacy, IT, and other functional partners to embed quality by design across systems and workflows.
Care Access is working to make the future of health better for all. With hundreds of research locations, mobile clinics, and clinicians across the globe, they bring world-class research and health services directly to communities that often face barriers to care.
Monitor individual and team performance goals under the Director of Operations.
Serve as a SME when working with development, implementation and technology.
Provide guidance on work processes, seek efficiencies, and improve effectiveness.
CI Azumano is Seneca Holdings' full-service travel management company for businesses, governments, and personal travelers, offering 24/7 support. They value their team and provide a balanced mix of benefits, flexible work-life balance, and professional development opportunities.
Oversees daily operations of the Care Management unit and ensures process implementation.
Facilitates staff development, provides regular performance feedback, and identifies areas of improvement.
Evaluates performance metrics, supports staff in care planning, and promotes interdisciplinary collaboration.
Capital Blue Cross promises to go the extra mile for our team and our community. They offer a caring team of supportive colleagues and invest heavily in training and continuing education. Employees consistently vote them one of the “Best Places to Work in PA.”
Utilizing healthcare experience to perform audit recovery procedures.
Identifying and validating incorrect claim payments.
Researching reimbursement regulations for claim payment compliance reviews and documentation to support current audit findings.
Cotiviti Healthcare is the payment accuracy expert, working with healthcare organizations to recover money, improve processes, strengthen relationships, and maximize their value. They are a well-established company with competitive pay, opportunities to develop professionally, and excellent benefits.
Perform internal audits to ensure coding compliance and accuracy.
Develop and maintain coding education and training programs.
Collaborate with leadership to standardize coding practices.
Jobgether uses AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. They identify the top-fitting candidates, and this shortlist is then shared directly with the hiring company.
Oversee the daily operations of the Enrollment Specialist team, including planning daily team coverage for various tasks.
Ensure the efficient and accurate execution of all new patient onboarding processes, including effective management of incoming communications.
Lead, coach, and develop a team of Enrollment Specialists, providing ongoing performance feedback, conducting regular one-on-one meetings, and completing annual performance evaluations to ensure high-quality service and productivity.
Form Health is a virtual obesity medicine clinic delivering multi-disciplinary evidence-based obesity treatment through telemedicine. Form Health is a venture-backed innovative startup with an experienced clinical and leadership team deeply invested in our core value to put patients first, and also deeply committed to creating a culture where every employee is valued and we learn and improve together.
Conduct audits of payer processed claims to verify accurate reimbursement.
Conduct post-implementation Care Center audits following the audit policy.
Assist the Manager, RI, in leading initiatives that drive efficiency.
Privia Health is a technology-driven physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices. Their platform consists of scalable operations and cloud-based technology to reduce healthcare costs and improve patient outcomes.
Provide comprehensive leadership and strategic oversight to the hearings team and independent contractors.
Lead coaching sessions to foster development, accountability, and continuous improvement while conducting regular 1:1's in addition to mid-year and annual reviews.
Be the primary escalation point for complex hearing scenarios and internal team concerns, offering guidance and resolution for high impact accounts or escalated issues.
Experian is a global data and technology company, powering opportunities for people and businesses around the world. As a FTSE 100 Index company listed on the London Stock Exchange (EXPN), they have a team of 22,500 people across 32 countries and corporate headquarters are in Dublin, Ireland.
Acts as the clinical coding subject matter expert and lead coding resource across the organization.
Acts as a resource and provides education to providers on clinical coding standards.
Coordinates and leads the Alliance Coding Workgroup.
Central California Alliance for Health is a regional non-profit health plan that provides accessible, quality health care. The company has over 500 employees and fosters a respectful, diverse, professional, and fun culture where employees are empowered to do their best work.
Manage and drive continuous process improvement initiatives.
Oversee all daily, end to end, clinical trial/patient matching operations.
Serve as a liaison between trial sites, sponsors, and drive project delivery.
Natera is a global leader in cell-free DNA (cfDNA) testing, dedicated to oncology, women’s health, and organ health. The Natera team consists of highly dedicated statisticians, geneticists, doctors, laboratory scientists, business professionals, software engineers and many other professionals from world-class institutions, who care deeply for their work and each other.
Responsible for making sure audit requests are treated on time and audit bookings are smoothly performed.
Key contact point for audit booking and the essential link between customers and a smooth audit process.
Accountable for the smooth audit booking process.
Eurofins Scientific provides analytical testing services to clients across multiple industries, to make life and our environment safer, healthier and more sustainable. With 55,000 staff across a decentralized and entrepreneurial network of 900 laboratories in over 50 countries, they are the global leader in food, environment, pharmaceutical and cosmetic product testing.
Drive collaboration and coordination with cross-functional teams.
Track team progress and deliver detailed status reports, including KPIs and performance data.
Audit call and email communications to assess quality and accuracy; compile QA feedback summaries for management and training teams.
Natera is a global leader in cell-free DNA (cfDNA) testing, dedicated to oncology, women’s health, and organ health. The Natera team consists of highly dedicated statisticians, geneticists, doctors, laboratory scientists, business professionals, software engineers and many other professionals from world-class institutions, who care deeply for our work and each other.
Oversee teams of Claims Analysts and ensure high standards of quality and service are met.
Guide team members through complex claims processing and customer service inquiries.
Foster team development and drive improvements within the department.
Jobgether uses an AI-powered matching process to ensure applications are reviewed quickly, objectively, and fairly against the role's core requirements. The system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company.
Manage day-to-day operations of the Revenue Integrity department.
Lead project planning sessions and ensure timely and accurate delivery of outcomes.
Cultivate relationships within the healthcare community and manage client interactions.
They are a company working with partner companies. They use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements.
Auditing incoming applications to ensure all required information is documented.
Handling multiple applications simultaneously with using BPM, Cactus, CAQH, and Facets.
Communicating effectively with providers and internal teams to resolve any issues and ensure smooth operations.
BlueCross BlueShield of Tennessee has been helping Tennesseans find their own unique paths to good health since 1945. At BCBST, they empower their employees to thrive both independently and collaboratively, creating a collective impact on the lives of their members.