Perform advanced healthcare payment audits by analyzing claims data and identifying discrepancies.
Develop and improve audit concepts focused on payment accuracy and reimbursement policies.
Collaborate with audit, engineering, and business teams to ensure accurate findings and process improvements.
Jobgether is an AI-powered job matching platform that uses technology to connect candidates with roles. The company operates remotely and focuses on efficient, objective hiring processes.
Perform retrospective and concurrent Quality Assurance audits of inpatient encounters for accuracy and compliance.
Identify areas of educational opportunities and provide feedback to Coding Leadership.
Audit scope includes both government and commercial payors including RAC and ACHA.
Baptist Health is a faith-based, not-for-profit health system providing preventive and specialty care in Northeast Florida through over 200 locations and six hospitals. Recognized as a top workplace and most preferred provider for more than 25 years, it was recently named a top employer for diversity by Forbes.
Review patient records and healthcare documentation to ensure compliance with regulatory standards.
Evaluate accuracy and completeness of clinical documentation, including OASIS guidelines and coding.
Collaborate with interdisciplinary teams to enhance patient outcomes through quality improvement initiatives.
Jobgether is a job platform that uses AI-powered matching to connect candidates with hiring companies. They partner with various employers to manage recruitment processes.
Oversees a team of Clinical Validation Auditors to ensure productivity and quality standards are met.
Manages queue distribution, performance optimization, and training for new hires and existing staff.
Collaborates with Auditors and Quality Assurance to produce high-quality recoverable claims and meet client SLAs.
Cotiviti provides healthcare auditing and analytics solutions to help clients recover overpayments and improve compliance. The company fosters a collaborative and team-oriented culture with a focus on quality and employee development.