9 senior clinical compliance auditor jobs found in Flowood, MS

Healthy Careers Start Here At Blue Cross & Blue Shield of Mississippi, we encourage professional growth in a challenging and fast-paced atmosphere. Our 'be healthy' culture promotes health and wellness at all levels of the Company, and we provide our employees with the time, tools and resources to commit to a healthy lifestyle. 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...

Senior Clinical Compliance Auditor page is loaded## Senior Clinical Compliance Auditorlocations: Flowood, MStime type: Full timeposted on: Posted 2 Days Agojob requisition id: JR100294# Healthy Careers Start HereAt Blue Cross & Blue Shield of Mississippi, we encourage professional growth in a challenging and fast-paced atmosphere. Our 'be healthy' culture promotes health and wellness at all levels of the Company, and we provide our employees with the time, tools and resources to commit to a healthy lifestyle.# 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...

A leading health insurance provider in Mississippi is seeking a Senior Clinical Compliance Auditor. This role involves reviewing clinical data, coordinating and validating billing practices for healthcare providers, and working closely with various teams. Required qualifications include a Bachelor's degree in Nursing and at least three years of relevant experience. The ideal candidate will possess strong communication, organizational, and analytical skills. Join us to promote health and wellness throughout Mississippi. #J-18808-Ljbffr

Join to apply for the Coder 2 - Clinic, Patient Financial Services role at Our Lady of the Lake Health . To review and audit Network Provider medical records for documentation and coding compliance and quality with federal and state laws and regulations. Responsibilities Quality and Performance Improvement: research, develop, and implement standardized processes for quality monitoring of inpatient and outpatient coding and abstracting. Conduct quality audits for coding according to pre‑established criteria in coordination with the Coding and Reimbursement Specialist. Assist Management with evaluation of functions and processes of the coding area to determine opportunities to improve efficiency and quality. Implement innovative ideas and process changes. Attend meetings as required and strive to improve the quality of meetings by taking an active role in meeting topics. Participate in educational programs, in‑services, and training sessions to share expertise with others and...

Job Description To review and audit Network Provider medical records for documentation and coding compliance and quality with federal and state laws and regulations. Job Title Coder 2 - Clinic Responsibilities Quality and Performance Improvement: Research, develop and implement a standardized process for quality monitoring of inpatient and outpatient coding and abstracting. Conduct quality audits for coding according to pre‑established criteria in coordination with the Coding and Reimbursement Specialist. Assist Management with evaluation of functions and processes of the coding area to determine opportunities to improve the efficiency and quality of the coding area. Implement innovative ideas and process changes. Attends meetings as required and strives to improve the quality of meetings by taking an active role in meeting topics. Participates in educational programs, in‑services, and training sessions in an effort to share my/her own expertise with others and further the...

Welbehealth Pace Coding Auditor And Educator WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews...

A logistics service provider in Baton Rouge, LA is looking for a Vendor Compliance Auditor to ensure the quality and compliance of incoming loads. This role involves auditing loads, identifying deviations, and documenting root causes using tablet procedures. The ideal candidate will be detail-oriented and able to communicate violations effectively. Compensation is $18/hour, paid weekly, with the shift set at the time of hire. This position is critical for maintaining high industry standards. #J-18808-Ljbffr

Join to apply for the Coder 2 - Clinic role at Our Lady of the Lake Health Be among the first 25 applicants (Posted 4 days ago) To review and audit Network Provider medical records for documentation and coding compliance and quality with federal and state laws and regulations. Responsibilities Quality and Performance Improvement: research, develop and implement standardized processes for quality monitoring of inpatient and outpatient coding and abstracting. Conduct quality audits for coding according to pre‑established criteria in coordination with the Coding and Reimbursement Specialist. Assist management with evaluation of functions and processes of the coding area to determine opportunities to improve the efficiency and quality of the coding area. Implement innovative ideas and process changes. Attend meetings as required and strive to improve the quality of meetings by taking an active role in meeting topics. Participate in educational programs, in‑services, and...

Join to apply for the Coder 2 - Clinic role at Franciscan Missionaries of Our Lady University 2 days ago Be among the first 25 applicants Job Description To review and audit Network Provider medical records for documentation and coding compliancy and quality with federal and state laws and regulations. Responsibilities Quality and Performance Improvement Research, develops and implements standardized process for quality monitoring of inpatient and outpatient coding and abstracting. Conducts quality audits for coding according to pre-established criteria in coordination with the Coding and Reimbursement Specialist. Assists Management with evaluation of functions and processes of the coding area to determine opportunities to improve the efficiency and quality of the coding area. Implements innovative ideas and process changes. Attends meetings as required and strives to improve the quality of meetings by taking an active role in meeting topics. Participates in educational...