Conducts audits of clinical documentation reviews to ensure compliance and regulatory requirements.
Develop and deliver training sessions based on audit findings to support CDI team competency.
Oversee the accuracy, specificity, and completeness of clinical documentation.
Adventist HealthCare is a faith-based, not-for-profit organization dedicated to improving the health and well-being of people and communities. They employ over 6,000 professionals and are one of the longest serving healthcare systems in the Washington, D.C., area.
Perform chart scrubbing and clinical documentation audits to ensure completeness and accuracy.
Review records to validate ICD-10 diagnosis coding and supporting clinical documentation.
Ensure compliance with PDPM (Patient-Driven Payment Model) and CMS guidelines.
Limitlessli specializes in recruiting, hiring, and managing high-caliber remote staff for dynamic and growing healthcare facilities. Leveraging their extensive global network, they connect clients with highly qualified professionals, offering tailored services to meet clients' unique business needs.
Assists in the maintenance of structures and processes which support improvement and patient safety.
Uses clinical knowledge in formal and informal consultation with individual staff, clinicians and managers, to address clinical quality and safety concerns.
Participates in clinical adverse event task groups.
Dartmouth Health is a nationally recognized Academic Medical Center set in the White Mountains of New Hampshire, stretching over New Hampshire and Vermont. They offer a rigorous, research-focused environment and are anchored by the academic Dartmouth Hitchcock Medical Center in Lebanon, NH.
Responsible for planning and executing quality and oversight activities to ensure operational compliance.
Responsible for internal and external case audits for Capital and our delegated UM vendors.
Responsible for educating staff on findings, and the audit tool ensuring a consistent approach.
Capital Blue Cross promises to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.”
Develop and maintain a quality audit program for the Clinical Review Team.
Ensure high-quality reviews and adherence to regulatory requirements.
Deliver exceptional member, provider, and employee experiences.
SmithRx is a rapidly growing Health-Tech company that aims to disrupt the Pharmacy Benefit Management (PBM) sector using technology and customer service. The company has a mission-driven and collaborative culture, with hundreds of thousands of members onboarded since 2016.
Conduct quality reviews, audit revenue cycle claims and workflows against established standard operating procedures (SOPs).
Develop, collect, analyze, report and measure multiple quality improvement initiatives that supports RCM operational functions.
Identify potential deficiencies in processes via analysis and trends.
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care. The Privia Platform consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.
Responsible for submission of the patient’s medical record to CMS or their delegated representatives, other contracted agencies, patients, and privately subpoenaed charts.
Provide administrative support to the Director of Home Health in compliance with organization policies and procedures and applicable laws and regulations.
Develop and maintain tracking tools to assist management with monitoring progress on compliance and accreditation standards.
By The Bay Health, established in 1975, is a non-profit that set the standard for hospice in the U.S. by emphasizing the role of the patient in making important medical decisions. Their spectrum of home-based services includes Skilled Home Health Care, Palliative Care, Adult Hospice Care and Pediatric Care.
Review doctor-patient messages across platforms to ensure quality.
Ensure all communication aligns with clinical guidelines and company policies.
Provide structured feedback to providers and internal teams.
Homera Health builds tech, marketing, and growth engines for successful telehealth brands. As they expand into new verticals, they are hiring talent across various domains to build the next generation of virtual healthcare experiences.
Own the execution of clinician chart audits and watchlist tracking.
Investigate clinical incidents, chart audits, and collaborate on root cause documentation.
Track quality, safety, and clinician performance metrics using manual and automated tools.
Wheel is evolving the traditional care ecosystem by equipping the nation's most innovative companies with a premier platform to deliver high-quality virtual care at scale. They offer proven strategies and cutting-edge technologies to foster consumer engagement, build brand loyalty, and maximize return on investment.
Perform coding audits and reviews on a variety of professional fee record types.
Perform necessary research in order to provide the client with supportive regulatory and coding guideline documentation.
Assist in the design and presentation of educational seminars to clients and staff
UASI is an award-winning company with over 40 years of experience, offering consulting services. We have enduring partnerships with our valued clients, stability, and long-term success of our dedicated team.
Conduct audits comparing medical record documentation to reported codes.
Research, interpret and communicate federal and state laws and guidelines pertaining to CMS and Medicare.
Provide feedback, education, training, and technical support with regard to proper documentation guidelines, service selection, charge capture, supervision and coding principles.
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. Their platform consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.