133 associate director audit management jobs found

Inspire health. Serve with compassion. Be the difference. Job Summary Responsible for leading coding teams, coder training, work que management, performing prebill and second-level coding reviews utilizing auditing software and documents findings to improve CC/MCC capture, Risk Variable capture, HAC/PSI, HCC and Quality Indicator validation. Uses knowledge of coding and compliance guidelines to identify potential documentation, coding and reimbursement issues and report these to coding leadership. Employ critical thinking skills to alert coding leadership to any trends identified in their reviews and to make suggestions for continual process improvement. Reviews and responds to inpatient denials as needed. Performs Inpatient coding by assigning ICD-CM and ICD-PCS codes as well as DRG assignment. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference....

Inspire health. Serve with compassion. Be the difference. Job Summary Responsible for leading coding teams, coder training, work que management, performing prebill and second-level coding reviews utilizing auditing software and documents findings to improve CC/MCC capture, Risk Variable capture, HAC/PSI, HCC and Quality Indicator validation. Uses knowledge of coding and compliance guidelines to identify potential documentation, coding and reimbursement issues and report these to coding leadership. Employ critical thinking skills to alert coding leadership to any trends identified in their reviews and to make suggestions for continual process improvement. Reviews and responds to inpatient denials as needed. Performs Inpatient coding by assigning ICD-CM and ICD-PCS codes as well as DRG assignment. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference....

Associate Director, Clinical PV & Medical Quality, CPMQ Global Regions Join to apply for the Associate Director, Clinical PV & Medical Quality, CPMQ Global Regions role at Takeda . Base pay range: $153,600.00/yr - $241,340.00/yr. U.S. based employees may be eligible for short?term and/or long?term incentives and a variety of benefits including medical, dental, vision, 401(k), disability, life insurance, tuition reimbursement, paid volunteer time off, holidays, well?being benefits, up to 80 hours sick time and 120 hours paid vacation for new hires. Salary will reflect qualifications, experience, education, certifications, location, and applicable wage requirements. OBJECTIVES Provides oversight from a clinical research and pharmacovigilance perspective of regulated post?authorization activities in the commercial business units and affiliates. Contributes to and implements the engagement strategy among R&D, Business Units and affiliates and Quality to...

Associate Director, Clinical Trial Lead (on-site Billerica, MA) Join EMD Serono, Inc. as an Associate Director, Clinical Trial Lead (on-site Billerica, MA). Work Your Magic with us! Start your next chapter and join EMD Serono. Ready to explore, break barriers, and discover more? We know youve got big plans so do we! Our colleagues across the globe love innovating with science and technology to enrich peoples lives with our solutions in Healthcare, Life Science, and Electronics. Together, we dream big and are passionate about caring for our rich mix of people, customers, patients, and planet. That's why we are always looking for curious minds that see themselves imagining the unimaginable with us. This role does not offer sponsorship for work authorization. External applicants must be eligible to work in the US. Your role Manages multiple studies, projects, and work streams with high complexity, risk, impact and reach, typically Ph III and registrational/sourcing...

Associate Director, Medical Device Quality Join to apply for the Associate Director, Medical Device Quality role at Viridian Therapeutics, Inc. About the Role Reporting to the Sr. Director, Medical Device Quality, the Associate Director is responsible for providing leadership and compliance oversight of quality activities associated with medical devices and combination product development that meet applicable regulatory requirements and industry standards. The role supports the development and manufacturing of combination products at contract manufacturing organizations (CMOs) and is based in our Waltham, MA headquarters. Office?based employees are required to work in the office three (3) days a week. Responsibilities Represent medical device quality as subject matter expert and core team member on device development projects. Support design and development phases, clinical readiness, commercial approval/launch, and regulatory submissions of Viridian combination...

Associate Director, Medical Review Committee Operations At Insmed, every moment and every patient counts - and so does every person who joins in. As a global biopharmaceutical company dedicated to transforming the lives of patients with serious and rare diseases, you'll be part of a community that prioritizes the human experience, celebrates curiosity, and values every person's contributions to meaningful progress. For patients, for each other, and for the future of science, we're in. Are you? About the Role The Associate Director, Medical Review Committee (MRC) Operations is responsible for managing the operational execution of the company's Global Medical Review Operations, overseeing the full lifecycle of the medical materials review and approval process. You will ensure efficient coordination of MRC activities, compliance with company policies and regulatory standards, and the quality and integrity of all reviewed materials. By driving process excellence, governance, and...

Pay Range: Pay Range:$47.69 - $67.19Ensure SEARHC meets federal and state regulations and internal policies in regard to healthcare coding, documentation, and billing practices. Review health records to verify coding and clinical documentation meets applicable coding and billing requirements, Medicare/Medicaid regulations, federal and state laws, and SEARHC policy. SEARHC is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement. Working at SEARHC is more than a job, it's a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health insurance, dental, and vision benefits, life insurance and long and short-term disability, and more. Key Essential Functions and Accountabilities of the Job Conduct Audits: Review...

Compliance Auditor page is loaded## Compliance Auditorlocations: AK - Juneautime type: Full timeposted on: Posted Yesterdayjob requisition id: JR102042Pay Range:Pay Range:$47.69 - $67.19SEARHC is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement.Working at SEARHC is more than a job, it’s a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health, dental, and vision benefits, life insurance and long and short-term disability, and more.Ensure SEARHC meets federal and state regulations and internal policies in regard to healthcare coding, documentation, and billing practices. Review health records to verify coding and clinical documentation meets applicable coding and billing requirements, Medicare/Medicaid...

GoTo Telemed seeks an exceptional  Remote Medical Biller  to manage comprehensive Revenue Cycle Management (RCM) operations for our rapidly expanding telehealth platform serving multiple medical specialties and healthcare providers nationwide. As a key member of our distributed RCM team, you will process, manage, and optimize medical claims for an increasing portfolio of telehealth providers—with new clients and provider networks added every month as our organization scales. In this critical role, you will be the financial backbone of our provider network, managing the complete end-to-end billing lifecycle including patient eligibility verification, insurance claim submission, payment posting, accounts receivable follow-up, and comprehensive denial management. Your expertise in medical coding (CPT, ICD-10-CM, HCPCS), telehealth modifiers, payer policies, and compliance will directly impact provider revenue, patient satisfaction, and our organizational growth trajectory. This...

GoTo Telemed seeks an exceptional  Remote Medical Biller  to manage comprehensive Revenue Cycle Management (RCM) operations for our rapidly expanding telehealth platform serving multiple medical specialties and healthcare providers nationwide. As a key member of our distributed RCM team, you will process, manage, and optimize medical claims for an increasing portfolio of telehealth providers—with new clients and provider networks added every month as our organization scales. In this critical role, you will be the financial backbone of our provider network, managing the complete end-to-end billing lifecycle including patient eligibility verification, insurance claim submission, payment posting, accounts receivable follow-up, and comprehensive denial management. Your expertise in medical coding (CPT, ICD-10-CM, HCPCS), telehealth modifiers, payer policies, and compliance will directly impact provider revenue, patient satisfaction, and our organizational growth trajectory. This...

GoTo Telemed seeks an exceptional  Remote Medical Biller  to manage comprehensive Revenue Cycle Management (RCM) operations for our rapidly expanding telehealth platform serving multiple medical specialties and healthcare providers nationwide. As a key member of our distributed RCM team, you will process, manage, and optimize medical claims for an increasing portfolio of telehealth providers—with new clients and provider networks added every month as our organization scales. In this critical role, you will be the financial backbone of our provider network, managing the complete end-to-end billing lifecycle including patient eligibility verification, insurance claim submission, payment posting, accounts receivable follow-up, and comprehensive denial management. Your expertise in medical coding (CPT, ICD-10-CM, HCPCS), telehealth modifiers, payer policies, and compliance will directly impact provider revenue, patient satisfaction, and our organizational growth trajectory. This...

GoTo Telemed seeks an exceptional  Remote Medical Biller  to manage comprehensive Revenue Cycle Management (RCM) operations for our rapidly expanding telehealth platform serving multiple medical specialties and healthcare providers nationwide. As a key member of our distributed RCM team, you will process, manage, and optimize medical claims for an increasing portfolio of telehealth providers—with new clients and provider networks added every month as our organization scales. In this critical role, you will be the financial backbone of our provider network, managing the complete end-to-end billing lifecycle including patient eligibility verification, insurance claim submission, payment posting, accounts receivable follow-up, and comprehensive denial management. Your expertise in medical coding (CPT, ICD-10-CM, HCPCS), telehealth modifiers, payer policies, and compliance will directly impact provider revenue, patient satisfaction, and our organizational growth trajectory. This...

Overview Job Description - Director, Coding Auditor & Educator (7410-2297) LifePoint Health Support Center Description The Director, Coding Auditor and Educator is responsible for reviewing and auditing hospital medical records for coding completeness and accuracy. This position identifies potential coding and DRG error and researches appropriate coding guidelines to support recommended changes. This position will communicate these changes in a timely manner. This position will provide coding education and expert coding advice to the coding staff. The Director, Coding Auditor and Educator will develop education/training materials including the development of coding guidelines, policies and procedures. This individual would demonstrate proficiency in auditing principles (including re-auditing). This individual communicates with IRM, Group Leadership, Ethics and Compliance Department members, hospital HIM coding and DI regarding coding audit issues, current coding regulations...

Description At Viridian, we are focused on developing best-in-class medicines for people living with autoimmune and rare diseases. Leveraging our team's expertise in antibody discovery and engineering, we have created a robust pipeline of differentiated investigational therapeutic candidates for well-validated targets. Reporting to the Sr. Director, Medical Device Quality, the Associate Director is responsible for providing leadership and compliance oversight of quality activities associated with medical devices and combination product development that meet applicable regulatory requirements and industry standards. The Associate Director will play a critical role in development and manufacturing of combination products at contract manufacturing organizations (CMOs). This role is based in our Waltham, MA headquarters. Our office-based employees are required to work in the office three (3) days a week. Responsibilities (including, but not limited to): • Represent medical...

Health Information Management Coder Accurately and efficiently codes and abstracts comprehensive acute care inpatient, rehabilitation inpatient, outpatient surgery, swing bed, long term care, ancillary services and short stay observation patient records according to official coding guidelines for accurate coding and benchmarks for productivity. Evaluates and assigns accurate DRG, PAI, and APC assignment. The position responsibilities include 95% comprehensive assignment of inpatient ICD 9 diagnosis, DRG, Ambulatory Patient Classification assignments, comprehensive review of the entire inpatient, observation, or ambulatory record, accurate documentation capture for accurate and compliant code and procedure assignment. Responsibility includes occasional backup for diagnostic outpatients. Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include: Supportive work culture Medical, Vision and Dental Coverage Retirement Plans,...

At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. Primary Function/General Purpose of Position The Speech Language Pathologist works to prevent, assess, diagnose, and treat speech, language, social communication, cognitive-communication, and swallowing disorders in children and adults. They perform patient evaluations, and re-evaluations, regarding the application of a wide variety of therapeutic techniques with special attention to receptive and expressive language skills, speech fluency, vocal and oral motor competence, articulation, and auditory skills. The Speech Language Pathologist establishes patient treatment plans based upon the referral from the physician/referral source. Essential Job Functions ? Reviews physician referral, patient's condition, and medical history to determine speech...

Coder Individual is responsible for coding all OP work types for the purpose of reimbursement, research, and compliance with federal regulations. Applies ICD-10 diagnosis and CPT procedure codes and appropriate APC or E-APG. Coder must abstract statistical data from records into hospital abstracting system in accordance with hospital policies and procedures. Individual must have knowledge of ICD-10, CPT, APCs, E-APG's, federal and state coding guidelines. Responsibilities Reviews patient's entire current medical record and assigns appropriate ICD-10 diagnosis and CPT procedure codes according to accepted coding guidelines and hospital's policies and procedures. Assigns accurate APC and E-APG's to patient's record utilizing hospital encoding system. Corrects any edits flagged by encoder and financial system. Understands and applies modifiers appropriately. Accurately abstracts statistical data from records using hospital abstracting system. Attends hospital sponsored...

PURPOSE OF THIS POSITION This position is responsible for all medical claims including pre-billing and follow up activities for delayed claims by ensuring, through various activities, that claims are clean and should be paid promptly by insurers without requiring further intervention. This staff member performs all pre-claim submission activities, including verifying existing information is accurate, determining when additional data is needed, and collecting necessary details to ensure claims are complete. Additionally, this individual follows departmental productivity and quality control measures that support the organization’s operational goals. This position promotes revenue integrity and accurate reimbursement for the organization by ensuring timely and accurate billing, timely payer follow-up activities and collection of accounts. JOB DUTIES/RESPONSIBILITIES Duty 1: Maintains a thorough understanding and education of federal and state regulations and payer specific policies...