4 (CPMA) Certified Professional Medical Auditor jobs

Job Description Job Description Growing Healthcare Receivable Management Company seeking a detail oriented full time Auditor to Analyze and follow up on patient accounts. Summary of Responsibilities: Follow up and analysis on hospital patient accounts, including follow up with third party payers Responsibilities: Review/Analyze Physician/Outpatient accounts to determine issue causing denial or delay of payment; Submit written claim/payment disputes as necessary; Review denials related to ICD-10 and CPT codes Review medical necessity denials due to lack of documentation/insufficient coding. Prepare and submit appeals for authorization denials/administrative denials as necessary; Follow up on status for Physician/ Outpatient/ claims and/or denials; Communicate with other departments in order to have accounts reviewed and obtain additional information needed to dispute claims issues as needed Required Qualifications: High School Diploma or GED, required...

The Clinical Research Quality Assurance Medical Auditor will work within the Office of Research Compliance and Integrity relying on their medical/clinical experience to conduct internal audits on clinical trials to ensure subject safety and to review research billing activity to ensure compliance with federal, state, and local regulations and internal policies and guidelines. Written reports and oral presentations of audit findings will be completed, presented to the Principal Investigator and Team, and action items followed to resolution. Train Study Team Staff on identified clinical trial compliance issues as needed. Why Nationwide Children's Hospital? The moment you walk through our doors, you feel it. When you meet our patient families, you believe it. And when you talk with anyone who works here, you want to be part of it. Welcome to Nationwide Children’s Hospital, Where Passion Meets Purpose . Here, Diversity, Equity and Inclusion are integrated into our core...

Job Description Job Description This is a great opportunity for someone who is detail oriented and experienced in 2023 EM coding guidelines. Although there is little to no direct provider interaction, the auditor should have excellent written communication skills to deliver clear audit results. The ideal candidate will take pride in providing the best quality of work and will be available to take on auditing projects as assigned in a timely manner. This is a remote opportunity that compensates the auditor per encounter through an independent contractor agreement. There are no set hours, just project work as business dictates. The right candidate will be a subject matter expert on EM and all the recent changes to those documentation requirements. Duties and Responsibilities: Audits medical or behavioral health record documentation to identify deficiencies in documentation in direct relationship to codes billed to carriers. Prepares reports of findings and clearly communicates...