126 associate director audit management jobs found

Job Description The Audit Management Associate Director is responsible for managing audit and inspection activities, including internal and external processes. This role involves designing and executing compliance audits across GMP suppliers through a risk-based audit program supporting Vertex's business functions. The role ensures adherence to regulations, industry standards, and Vertex policies, procedures, and quality standards as outlined in the Quality Management System. It may focus on manufacturing, distribution, laboratory, or clinical practices, applying specialized domain knowledge and providing technical recommendations to management. Key Duties and Responsibilities: Provide expertise and leadership in Medical Device / Combination Product Regulation. Contribute to the direction, performance, and effectiveness of the GMP audit program, ensuring quality risk management and compliance. Partner with QA leadership and business leaders to coordinate and align audit...

Job Description The Audit Management Associate Director is responsible for managing audit and inspection activities, including internal and external processes. This role involves designing and executing compliance audits across GMP suppliers through a risk-based audit program supporting Vertex's business functions. The role ensures adherence to regulations, industry standards, and Vertex policies, procedures, and quality standards as outlined in the Quality Management System. It may focus on manufacturing, distribution, laboratory, or clinical practices, applying specialized domain knowledge and providing technical recommendations to management. Key Duties and Responsibilities: Provide expertise and leadership in Medical Device / Combination Product Regulation. Contribute to the direction, performance, and effectiveness of the GMP audit program, ensuring quality risk management and compliance. Partner with QA leadership and business leaders to coordinate and align audit...

Job Description The Audit Management Associate Director is responsible for the audit and inspection management for assigned activities, inclusive of internal and external processes. This role has responsibility for design and execution of compliance audits across GMP suppliers through the development of a risk-based audit program designed to support activities across Vertex business functions. This role ensures adherence to applicable regulations, industry standards, and to Vertex policies, procedures, and quality standards as set forth in the Quality Management System. This role may be a generalist but more often specializes in manufacturing, distribution, laboratory, or clinical practices. Regularly applies specialized domain knowledge to assignments and provides technical recommendations to management. Key Duties and Responsibilities: Provides Medical Device/Combination Product Regulation expertise and leadership. Contributes to the overall direction of the GMP audit program,...

Hiring Department #upjobs The Department of University Physicians Job Description #upjobs (This Medical Coding Specialist position is a dual post linked to Job ID 54697 Medical Coding Specialist Certified(MCS-C) and the department will be hiring for seven positions. Final or offered title will be determined by qualifications of the final candidates) Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record...

Senior Manager/Associate Director Clinical Quality Assurance Auditor Nurix Therapeutics is a clinical stage biopharmaceutical company focused on the discovery, development, and commercialization of targeted protein degradation medicines, the next frontier in innovative drug design aimed at improving treatment options for patients with cancer and inflammatory diseases. Powered by a fully AI-integrated discovery engine capable of tackling any protein class, and coupled with unparalleled ligase expertise, Nurix’s dedicated team has built a formidable advantage in translating the science of targeted protein degradation into clinical advancements. Nurix aims to establish degrader-based treatments at the forefront of patient care, writing medicine’s next chapter with a new script to outmatch disease. Responsibilities and Duties: The Senior Manager/Associate Director of Clinical Quality Assurance Auditor is responsible for partnering with cross functional teams to manage the audit...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Under the direction of the Associate Director of Fee-For-Service Coding Education and with minimal supervision, the Provider/Coder Education Supervisor is responsible for the development and delivery of coding education materials, related to Fee-For-Service coding guidelines, coding updates, software updates, coding and billing compliance, and regulatory updates. The Provider/Coder Education Supervisor...

General Summary of Position Assists the MedStar Family Choice (MFC) compliance and privacy programs. Conducts both internal and external audits to ensure compliance with regulatory requirements. We recruit, retain, and advance associates with diverse backgrounds, skills, and talents equitably at all levels. Key Responsibilities    Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations.  Analyzes existing clinical policies and makes recommendations to improve program integrity and organization processes.   Assists in investigating potential compliance/privacy violations.  Assists with and tracks responses to external government inquiries, investigations, data requests, subpoenas, and fair hearings. Responds to government requests for claims data/information.  Assists with...

Director, Revenue Cycle Management Clinical Practices of the University of Pennsylvania (CPUP) Department: Ortho Administration Location: Penn Medicine University City – 3737 Market Street   Schedule: ·       Full-time, Per Departmental Needs   Job Summary: The Revenue Cycle Director is responsible for overseeing all revenue activities and organizing strategies to increase profitability and meet all financial objectives. They will review practice billing activities and generate ideas for innovative revenue programs. Areas of oversight include but are not limited to practice revenue cycle operations including pre-registration, financial clearance, documentation, coding, charging, and billing and collections practices. This position will analyze and review all departmental work queues for accuracy and timely competition. Promote and evaluate key performance indicators including but not limited to, self-pay collection...

General Summary of Position Assists the MedStar Family Choice (MFC) compliance and privacy programs. Conducts both internal and external audits to ensure compliance with regulatory requirements. We recruit, retain, and advance associates with diverse backgrounds, skills, and talents equitably at all levels. Key Responsibilities Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations. Analyzes existing clinical policies and makes recommendations to improve program integrity and organization processes. Assists in investigating potential compliance/privacy violations. Assists with and tracks responses to external government inquiries, investigations, data requests, subpoenas, and fair hearings. Responds to government requests for claims data/information. Assists with internal and...

Hiring Department Hiring department #upjobs The Department of University Physicians Job Description #upjobs (This Medical Coding Specialist Certified position is a dual post linked to Job ID 54698 -MCS - University Physicians, and the department will be hiring for seven positions.) Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of...

Senior Manager/ Associate Director, Medical Operations Zenas BioPharma is a global biopharmaceutical company committed to becoming a leader in the development and commercialization of immune-based therapies for patients around the world. With clinical development and operations globally, Zenas is advancing a deep and balanced global portfolio of potential first- and best-in-class autoimmune therapeutics in areas of high unmet medical need while meeting the value requirements of the dynamic global healthcare environment. The company’s pipeline continues to grow through our successful business development strategy. Our experienced leadership team and network of business partners drive operational excellence to deliver potentially transformative therapies to improve the lives of those living with autoimmune and rare diseases. We are seeking top talent who share our commitment to patients and have a track record of success in acquiring, developing and commercializing products across...

Description: Job Summary: Ensures all technical aspects of the assignment of diagnostic and procedure coding is carried out in accordance with established standards and is in compliance with CMS, NCQA, third party payors, other regulatory agencies and Kaiser Permanente policy. Functions includes, but are not limited to working charge review work queues for reimbursable accounts for all internal and external surgical services. Serves as a technical coder for all specialties. Assists supervisor in responding to coding questions from other levels of coders and in responding to providers. Conducts special projects and focused reviews of encounters as requested. Essential Responsibilities: Required to research and assign. HCPCS Level II codes for ambulatory surgical services and/or professional services performed. Ability to research, analyze and/or review detailed and high complexity code edits and transactions within the Kaiser Permanente system. Provides additional support...

Overview: USA Health is Transforming Medicine along the Gulf Coast to care for the unique needs of our community. USA Health is changing how medical care, education and research impact the health of people who live in Mobile and the surrounding area. Our team of doctors, advanced care providers, nurses, therapists and researchers provide the region's most advanced medicine at multiple facilities, campuses, clinics and classrooms. We offer patients convenient access to innovative treatments and advancements that improve the health and overall wellbeing of our community. Responsibilities: Performs correct coding (CPT4/ICD10) for provider services; audits services billed without prior coding review to ensure accuracy; provides education, payer coding updates and documentation to leaders and providers to ensure coding is being performed based on current guidelines; performs periodic reviews and ongoing audits of claims to ensure accuracy of coding/billing and sufficiency of...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching plans in...

Replies within 24 hours Coder VI Specialist - Hospital Inpatient (Remote) Location: Work From Home Pay: $22.70 - $33.77/hr (Based on Experience) ⏳ Duration: Full-Time Shift: Flexible (Mon-Fri, start between 4 AM - 11 AM, finish by 8 PM) Guaranteed Hours: 40/week Job Summary: We are seeking a Coder VI Specialist - Hospital Inpatient to accurately assign ICD-10 CM/PCS codes for hospital inpatient visits, ensuring proper DRG assignment. This role requires coding accuracy, auditing skills, and clinical documentation analysis in accordance with industry guidelines. Requirements: • Certifications: CCS, RHIT, or RHIA • Experience: 2+ years of acute inpatient coding • Location: Must reside in AL, FL, GA, IA, IL, IN, KY, LA, ME, MI, MO, NC, OH, OK, SC, TN, TX, VA, or WI • Skills: Strong knowledge of hospital inpatient coding & auditing Preferred: Associate/Bachelor's in Health Information Management Familiarity with natural language processing engines Key...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching plans in...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching plans in...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching plans in...

Overview: The Clinical Coder is responsible and accountable for reviewing medical record documentation and assigning codes for reimbursement and statistical purposes. Responsibilities: Dependent upon level of expertise defined in the Education/Training section: Maintains a working knowledge of coding fundamentals: ICD-9-CM coding for inpatient, outpatient, and/or physician services; HCPCS coding, namely CPT-4 for surgical procedures, for outpatient and/or physician services; and/or HCPCS coding, namely Evaluation and Management, for physician services. Maintains a working knowledge of coding guidelines: Official Guidelines for Coding and Reporting, American Hospital Associations Coding Clinics, and/or American Medical Associations CPT Assistant. Maintains a working knowledge of reimbursement as it relates to coding: the government prospective payment systems for inpatient, outpatient, and/or home health agencies, skilled nursing facilities, inpatient rehabilitation...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching plans in...

Job Description Coding Specialist is a nationally certified professional coder who educates and support Providers, Division Directors/Managers and clinical staff by providing ongoing coding training to ensure adherence to agency regulations. Coders will conduct random chart audits and provide direct feedback to providers. Coders will be responsible for investigating and answering provider coding questions. Coders will review various data/reports and provide additional feedback. Coders will routinely visit Providence Medical Groups (PMG) clinics and attend clinical meetings. Coders will stay current with annual updates to CPT and ICD-10 and HCPCS codes. Providence caregivers are not simply valued - they're invaluable. Join our team at Physician Management Group and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower...

OUTPATIENT MEDICAL CODER/AUDITOR (23691) Join to apply for the OUTPATIENT MEDICAL CODER/AUDITOR (23691) role at Laredo Technical Services, Inc. About Us Laredo Technical Services, Inc. provides staffing services to federal Government agencies all over the world. LTSi connects the right opportunities to the right people. With our experience in placing our Team Members throughout the United States and overseas, we excel at providing experienced, professional personnel for a wide range of Professional and Office Administration as well as Medical Services. JOB TITLE: OUTPATIENT MEDICAL CODER/AUDITOR GOVERNMENT AGENCY & LOCATION: NAVAL HEALTH CLINIC, QUANTICO POSITION TIMING: Immediate hire upon completion of all background and security investigations. POSITION INFORMATION: This will be a full-time on-site position with normal hours of operation from 7:30 A.M. 4:30 P.M. Monday through Friday, excluding Federal Holidays. Essential Duties And Responsibilities...

DHR Health - US:TX:Edinburg - Days Summary: MISSION STATEMENT: Our Mission is to improve the well-being of those we serve with a commitment to excellence: every patient, every encounter, every time. VISION: Our Vision is to create a world-class health system to advance medicine and increase access for the communities we serve by empowering caregivers to heal through compassion, knowledge, innovation, integrated care and excellence. POSITION SUMMARY: Under general supervision, analyzes patient medical records to assure that documentation by providers conforms to legal and procedural requirements. Assigns specified codes to medical diagnoses and/or clinical procedures. Interacts with physicians and other providers regarding billing and documentation policies and procedures. Audits medical charts and records for compliance with federal coding regulations and guidelines. Provides a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical...