116 community based contract compliance auditor jobs found

Community Based Contract Compliance Auditor, Central RegionIndianapolis, Indiana, United StatesAbout the JobWork Arrangement: OnsiteAgency Interview Type: Webcam onlyEngagement Type: ContractNote: Applications with resumes in PDF format will be automatically rejected. Only Word format resumes will be considered.Short Description:The Community Based Contract Compliance Auditor will be part of a regional team that provides on-site monitoring and reviews of DCS community based contracted provider businesses.Complete Description:The auditor will conduct on-site monitoring and reviews of DCS community based contracted provider businesses. The auditor will conduct reviews throughout DCS regions 9, 10, and 11 which covers the central part of the state. Community Based reviews will evaluate DCS services and billing to assure there are no errors and billing has been performed appropriately. The auditor will educate, recommend, and create plans of corrections when any errors are found. The...

Community Based Contract Compliance AuditorIndianapolis, Indiana, United StatesInterview Type: Webcam onlyWork Arrangement: OnsiteEngagement Type: ContractNote: Applications with resumes in PDF format will be automatically rejected. Only Word format resumes will be considered.Short Description:The Community Based Contract Compliance Auditor will be part of a regional team that provides on-site monitoring and reviews of DCS community based contracted provider businesses.Complete Description:On-site monitoring and reviews of DCS community based contracted provider businesses. The auditor will conduct reviews throughout DCS regions 9, 10, and 11 which covers the central part of the state. Community Based reviews will evaluate DCS services and billing to assure there are no errors and billing has been performed appropriately. The auditor will educate, recommend, and create plans of corrections when any errors are found.The auditor will conduct audits throughout the same regions as...

Role: Community Based Contract Compliance Auditor Location: Indianapolis IN on-site monitoring and reviews of Client community based contracted provider businesses. The auditor will conduct reviews throughout Client regions 9, 10, and 11 which covers the central part of the state. Community Based reviews will evaluate Client services and billing to assure there are no errors and billing has been performed appropriately. The auditor will educate, recommend and create plans of corrections when any errors are found. The auditor will conduct audits throughout the same regions as listed above. Community based audits will be a more comprehensive look at a providers practices from point of service to billing. The auditor will educate, recommend, and create plans of corrections as well as pursue any financial damages to the state within this process. The auditor will travel in a team to Client contracted provider locations to conduct reviews and audits. The auditor will also be...

A community service organization is seeking a Community Based Contract Compliance Auditor to join their regional team in Bloomington, Indiana. The auditor will conduct thorough on-site reviews of DCS contracted provider businesses, focusing on compliance with state policies and billing accuracy. This role demands strong communication skills, proficiency in Microsoft Suite, and the ability to formulate corrective action plans. Frequent travel to provider locations is required, making this a dynamic position within the DCS regions. #J-18808-Ljbffr

Overview The Community Based Contract Compliance Auditor will be part of a regional team that provides on-site monitoring and reviews of DCS community based contracted provider businesses. The auditor will conduct reviews throughout DCS regions 8, 12, 13, 14, 15, 16, 17, and 18 which covers the bottom half of the state. Community Based reviews will evaluate DCS services and billing to assure there are no errors and billing has been performed appropriately. The auditor will educate, recommend and create plans of corrections when any errors are found. The auditor will conduct audits throughout the same regions as listed above. Community based audits will be a more comprehensive look at a provider\'s practices from point of service to billing. The auditor will educate, recommend, and create plans of corrections as well as pursue any financial damages to the state within this process. The auditor will travel in a team to DCS contracted provider locations to conduct reviews and audits....

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Become a part of our caring community and help us put health first The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Description Looking for an opportunity to make an impact? At Leidos, we deliver innovative solutions through the efforts of our diverse and talented people who are dedicated to our customers’ success. We empower our teams, contribute to our communities, and operate sustainably. Everything we do is built on a commitment to do the right thing for our customers, our people, and our community. Our Mission, Vision, and Values guide the way we do business. Your greatest work is ahead! Leidos’ Defense Sector Mission Assurance is seeking a Lead Compliance Auditor to join our team and serve as the senior technical authority for audit execution across our manufacturing and production operations. The Lead Compliance Auditor plans, leads, and reports internal quality and compliance audits, owns the Layered Process Audit (LPA) program on the production floor, and verifies conformance to customer, contractual, governmental, and industry standards including ISO 9001, AS9100, CMMC, DFARS,...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and identify opportunities for...

Looking for an opportunity to make an impact? At Leidos, we deliver innovative solutions through the efforts of our diverse and talented people who are dedicated to our customers’ success. We empower our teams, contribute to our communities, and operate sustainably. Everything we do is built on a commitment to do the right thing for our customers, our people, and our community. Our Mission, Vision, and Values guide the way we do business. Your greatest work is ahead! Leidos’ Defense Sector Mission Assurance is seeking a Compliance Auditor to join our team in support of Quality activities across the sector. The Compliance Auditor plans, performs, and reports internal quality and compliance audits within a defense manufacturing and/or services environment, verifying conformance to customer, contractual, governmental, and industry standards including ISO 9001, AS9100, CMMC, DFARS, ITAR, FAR, and applicable Department of Defense (DoD) requirements. This position reports to the...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and identify opportunities for improvement...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and identify opportunities for...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and identify opportunities for...

Become a part of our caring community and help us put health first The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy...

Looking for an opportunity to make an impact? At Leidos, we deliver innovative solutions through the efforts of our diverse and talented people who are dedicated to our customers’ success. We empower our teams, contribute to our communities, and operate sustainably. Everything we do is built on a commitment to do the right thing for our customers, our people, and our community. Our Mission, Vision, and Values guide the way we do business. Your greatest work is ahead! Leidos’ Defense Sector Mission Assurance is seeking a Lead Compliance Auditor to join our team and serve as the senior technical authority for audit execution across our manufacturing and production operations. The Lead Compliance Auditor plans, leads, and reports internal quality and compliance audits, owns the Layered Process Audit (LPA) program on the production floor, and verifies conformance to customer, contractual, governmental, and industry standards including ISO 9001, AS9100, CMMC, DFARS, ITAR, FAR,...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and identify opportunities for...

Overview Certified Medical Coder required (AHIMA, AAPC, or PMI). Hybrid-Sunrise, Florida The Medical Coding Auditor conducts audits to provide investigative support related to potential fraud, waste, abuse and/or overpayment. Through post payment medical records review, the Medical Coding Auditor ensures appropriate coding on claims paid and maintains compliance documentation of any fraud, waste or abuse identified based on coding guidelines and regulatory and contract requirements. Essential Duties and Responsibilities Performs post payment medical record review audits of claims payments to identify potential fraud, waste, abuse and/or overpayment. Completes and maintains detailed documentation of audits including but not limited to coding guidelines reviewed, medical necessity documentation, decision methodology, and monetary discrepancies identified. Coordinates overpayment recoveries with the Fraud Investigative Unit Manager. Responsible for assisting the Fraud Investigative...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and identify opportunities for...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and identify opportunities for...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...