3 jobs found in Seneca

Coding Specialist Inspire health. Serve with compassion. Be the difference. Responsible for abstracting and validating CPT, ICD-10 and HCPCS codes for inpatient, outpatient and physician's office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines. Serves as a subject matter expert for assigned specialty. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. Abstracts/codes for assigned provider(s)/division(s) based on medical record documentation. Adheres to all coding and compliance guidelines. Utilizes appropriate coding software and coding resources in order to determine correct codes. Communicates billing related issues to assigned supervisor/manager and participates in meetings in order to improve overall billing, when applicable. Follows departmental...

Become a part of our caring community The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you will Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provider onsite education, based on business needs Collaboration with other market provider facing role Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data-driven educational materials and...

Compliance Auditor Join Endeavor as a detail-driven Compliance Auditor! The Compliance Auditor functions as staff to the Corporate Compliance Officer (CO) and serves as an in-house subject matter expert with respect to regulatory matters. The Compliance Auditor will provide internal stakeholders with directions on compliance audit issues and ensure adherence of compliance & regulatory standards. Responsible for ensuring compliance with governmental and internal requirements. Perform clinical audits and reviews throughout the agency which are designed to assess medical necessity, fidelity to best practices, quality of service delivery, and service outcome metrics, as necessary. What You'll Do: Conduct probe, targeted, and retrospective audits to ensure regulatory and contractual compliance. Analyze compliance issues and partner with the Corporate Compliance Officer (CO) to implement corrective actions. Support external audits and regulatory site visits; ensure audit...