8 medical auditor jobs found

Job Description: This position is 100% on-site in Flowood, Mississippi Job Summary: The Senior Clinical Compliance Auditor serves as the primary clinical reviewer of data analysis findings, referrals, appeals and complaints related to Network Hospitals, Providers, Pharmacies, and other entities or programs suspected of inappropriate billing of claims to Blue Cross & Blue Shield of Mississippi. The incumbent is responsible for selecting, obtaining, coordinating, monitoring, and reviewing medical records and other relevant information for clinical and coding assessment and validation of related billing of services provided to Blue Cross Blue Shield Customers. The Senior Clinical Compliance Auditor collaborates with data analysts, compliance auditors, and the Medical Director to identify aberrant trends in patient care, utilization, and billing practices. The incumbent works with a multidisciplinary team to determine appropriate interventions to address and resolve identified...

We are seeking a Sr. Compliance Auditor Trainer who will provide on-going training and support to physicians, non-physician providers, professional fee billing staff, clinic staff, administrators, and other affected personnel on documentation and billing requirements. Using auditing and analysis techniques, determines the adequacy of medical records documentation, coding and billing for all providers across all clinical specialties. Works in close collaboration with the clinical departments, Physicians Billing Service, and the Johns Hopkins Health System Compliance Office. The documentation audits are conducted as part of the School of Medicine's Quality Assurance Compliance Program. Prepares reports for the Senior Director, Director, and clinical departments regarding the status or results of the reviews. Summary results are presented to the Clinical Practice Association's Board of Governors, the University's Trustee Committee for Audits and Insurance and other appropriate...

Join to apply for the Medical Assistant Supervisor role at California Pacific Orthopaedics Welcome to California Pacific Orthopaedics – the Bay Area’s premier orthopedic and sports‑related injury treatment provider! Our commitment to innovation is second to none, and we pride ourselves on offering the most advanced treatments, the latest technology, and the least invasive techniques in the field. With two convenient locations in San Rafael and San Francisco, we are highly computerized and strictly adhere to HIPAA privacy guidelines. Our focus is solely on serving our patients with the highest levels of expertise and customer service. We are a dynamic team that works hard to support each other. Our talented professionals are driven to offer the best patient care and are led by thoughtful leadership. Our leadership team understands the importance of work‑life balance and ensures that employees have the flexibility to care for themselves and their families. We are currently...

Abstractor/Coder I – Biological Sciences Division, University of Chicago Join to apply for the Abstractor/Coder I role at the Biological Sciences Division at the University of Chicago . Base pay range: $25.95/hr – $37.98/hr Department BSD UCP – Professional Billing Coding – Medical Specialty About the Department The Biological Sciences Division (BSD) and the University of Chicago Medical Center (UCMC) are managed by a single Dean/Executive Vice President and comprise the largest unit of the University, accounting for 60% of its annual budget. All physician, hospital, and clinic services are managed through the Medical Center, which is a $1.3 billion enterprise. The BSD includes the Pritzker School of Medicine, approximately 20 academic units, degree‑granting committees, and research centers and institutes. The BSD is located on the University’s main campus in Hyde Park, ten minutes south of downtown Chicago. BSD’s patient care operations are conducted primarily at the...

Join to apply for the Abstractor/Coder I role at University of Chicago . Pay Range $25.95/hr - $37.98/hr (base pay) Department BSD UCP - Professional Billing Coding - Medical Specialty. The Biological Sciences Division (BSD) and the University of Chicago Medical Center (UCMC) are managed by a single Dean/Executive Vice President and comprise the largest unit of the University, accounting for 60% of its annual budget. All physician, hospital, and clinic services are managed through the Medical Center, a $1.3 billion enterprise. The BSD includes the Pritzker School of Medicine, approximately 20 academic units, degree‑granting committees, and research centers and institutes. It is located on the University’s main campus in Hyde Park, ten minutes south of downtown Chicago. BSD’s patient care operations are conducted primarily at the University of Chicago Hospital and clinics on the same campus. The University of Chicago Practice Plan (UCPP) supports the clinical activity of nearly...

* Obtain appropriate reimbursement levels for professional services by reviewing and coding medical procedures, diagnoses, and physician visits.* Analyze denial and rejection reports, and appeal wherever appropriate.* Submit charges in a timely manner.* Work in collaboration with the Clinical Revenue Supervisor and others, provide guidance to faculty and staff on the charge capture and documentation processes.* Educate physicians and support staff on coding issues, including issues related to fraud and abuse as it relates to coding/professional billing/clinical documentation.* Attend and participate in meetings related to clinical revenue production and compliance.* Track physicians on inpatient service and ensure charges are captured for services provided.* Manage tracking log.* Audit and provide feedback to all providers rotating on inpatient service.* Other duties as assigned.* Thorough working knowledge of medical terminology, anatomy and physiology, as demonstrated by...