Coding Data Quality Auditor CVS Health CorpCoding Data Quality AuditorWork At Home, NM$18.50–$38.82 / hourResponsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures. Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories CRC (HCC)CPMA (Certified Professional Medical Auditor), CDEO (Certified Documentation Expert Outpatient) or CPC-I (Certified Professional Coding Instructor) preferred.
Profee Remote Auditor/Educator Presbyterian Healthcare ServicesProfee Remote Auditor/EducatorNMRemoteResponsibilities: With minimal supervision directly supports the following responsibilities of the Coding and documentation quality assurance (CDQA) team: implementation of and compliance to enterprise-wide and department coding policies and procedures for PHS; compliance to all external regulatory agency coding rules and regulations; Demonstrates high-level of proficiency in performing and/or managing on-site internal audits or reviews to assess compliance/quality monitoring performed by PHS/PMG departments while serving as a resource on documentation, coding, billing, and coding compliance questions. Provides support via auditing and training the enterprise-wide corrective action plans for coding, audit, physician and clinician personnel identified as low performers; perform medical record and billing reviews of denied and appealed claims and takes appropriate action to ensure accurate payment of claims; coordinate review and tracking of appealed claims including the communication process with affected payers; research and interpret all regulatory agency regulations.
Remote Pro Fee Auditor/Educator Presbyterian Healthcare ServicesRemote Pro Fee Auditor/EducatorRemote Workers New Mexico, NMRemoteWith minimal supervision directly supports the following responsibilities of the Coding and documentation quality assurance (CDQA) team: implementation of and compliance to enterprise-wide and department coding policies and procedures for PHS; compliance to all external regulatory agency coding rules and regulations; Demonstrates high-level of proficiency in performing and/or managing on-site internal audits or reviews to assess compliance/quality monitoring performed by PHS/PMG departments while serving as a resource on documentation, coding, billing, and coding compliance questions. Provides support via auditing and training the enterprise-wide corrective action plans for coding, audit, physician and clinician personnel identified as low performers; perform medical record and billing reviews of denied and appealed claims and takes appropriate action to ensure accurate payment of claims; coordinate review and tracking of appealed claims including the communication process with affected payers; research and interpret all regulatory agency regulations.
Auditor, Healthcare Services (RN) Molina Healthcare IncAuditor, Healthcare Services (RN)Santa Fe, NMPerforms audits in utilization management, care management, member assessment, behavioral health, and/or other clinical teams, and monitors clinical staff for compliance with National Committee for Quality Assurance, Centers for Medicare and Medicaid Services (CMS), and state/federal guidelines and requirements. At least 2 years health care experience, with at least 1 year experience in utilization management, care management, and/or managed care, or equivalent combination of relevant education and experience.
Night Auditor 1001 Nights IncNight AuditorSanta Fe, NMJOB OBJECTIVE: As a member of the Inn of The Five Graces the Night Auditor is to assist with all guest reservation needs or requests prior to their arrival and while in house. While performing the duties of this job, the employee will be working within a well-lit and medium sized workspace and will be exposed to outside weather.
Revenue Cycle Auditor RN - Full time, Day, Remote Providence St. Joseph HealthRevenue Cycle Auditor RN - Full time, Day, RemoteSanta Fe, NMRemoteTogether, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Revenue Cycle Auditor RN - Full time, Day, Remote Providence Health & ServicesRevenue Cycle Auditor RN - Full time, Day, RemoteNew Mexico, NMRemoteRequsition ID: 437237 Company: Providence Jobs Job Category: Revenue Cycle Operations Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Day Career Track: Nursing Department: 4001 SS RC REV INTEGRITY Address: OR Portland 4400 NE Halsey St Work Location: Providence Health Plaza (HR) Bldg 1-Portland Workplace Type: On-site Pay Range: $See Posting - $See Posting The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
IT Internal Audit Senior Stride, Inc.IT Internal Audit SeniorSanta Fe, New MexicoThe IT Internal Audit Senior executes IT General Controls (ITGC) and IT Application Controls (ITAC) testing as part of the company's SOX compliance program, while also planning and executing risk-based IT internal audits across the broader technology environment. Bachelor's degree in a major or concentration relevant to the position, such as Accounting, Business Administration, Risk Management, Information Systems, Management Information Systems, Computer Information Systems, or a related field .