9 quality assurance nurse auditor nurse analyst coding auditor jobs found

Job Description Job Description POSITION DESCRIPTION PYA is seeking a Quality Assurance Nurse Auditor/Nurse Analyst/Coding Auditor to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will be a member of the Revenue and Compliance Advisory Team . For more information about PYA, please visit: www.pyapc.com RESPONSIBILITIES Provide advisory services to ambulatory care, acute care, and post-acute care organizations, including documentation review and improvement for: Medical Necessity Level of Care Appropriateness of service and service location Billing documentation requirements and analysis of UB-04, Remittance Advices and Itemized Bills Assist with coding compliance reviews including professional, hospital outpatient, and inpatient hospital services Assist with regulatory compliance for Medicare, Medicaid, and third-party payers to include ambulatory, acute care (inpatient and...

Job Description Job Description POSITION DESCRIPTION PYA is seeking a Quality Assurance Nurse Auditor/Nurse Analyst/Coding Auditor to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will be a member of the Revenue and Compliance Advisory Team . For more information about PYA, please visit: www.pyapc.com RESPONSIBILITIES Provide advisory services to ambulatory care, acute care, and post-acute care organizations, including documentation review and improvement for: Medical Necessity Level of Care Appropriateness of service and service location Billing documentation requirements and analysis of UB-04, Remittance Advices and Itemized Bills Assist with coding compliance reviews including professional, hospital outpatient, and inpatient hospital services Assist with regulatory compliance for Medicare, Medicaid, and third-party payers to include ambulatory, acute care (inpatient and...

Job Description Job Description POSITION DESCRIPTION PYA is seeking a Quality Assurance Nurse Auditor/Nurse Analyst/Coding Auditor to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will be a member of the Revenue and Compliance Advisory Team . For more information about PYA, please visit: www.pyapc.com RESPONSIBILITIES Provide advisory services to ambulatory care, acute care, and post-acute care organizations, including documentation review and improvement for: Medical Necessity Level of Care Appropriateness of service and service location Billing documentation requirements and analysis of UB-04, Remittance Advices and Itemized Bills Assist with coding compliance reviews including professional, hospital outpatient, and inpatient hospital services Assist with regulatory compliance for Medicare, Medicaid, and third-party payers to include ambulatory, acute care (inpatient and...

Job Description Job Description POSITION DESCRIPTION PYA is seeking a Quality Assurance Nurse Auditor/Nurse Analyst/Coding Auditor to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will be a member of the Revenue and Compliance Advisory Team . For more information about PYA, please visit: www.pyapc.com RESPONSIBILITIES Provide advisory services to ambulatory care, acute care, and post-acute care organizations, including documentation review and improvement for: Medical Necessity Level of Care Appropriateness of service and service location Billing documentation requirements and analysis of UB-04, Remittance Advices and Itemized Bills Assist with coding compliance reviews including professional, hospital outpatient, and inpatient hospital services Assist with regulatory compliance for Medicare, Medicaid, and third-party payers to include ambulatory, acute care (inpatient and...

Job Description Job Description POSITION DESCRIPTION PYA is seeking a Quality Assurance Nurse Auditor/Nurse Analyst/Coding Auditor to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will be a member of the Revenue and Compliance Advisory Team . For more information about PYA, please visit: www.pyapc.com RESPONSIBILITIES Provide advisory services to ambulatory care, acute care, and post-acute care organizations, including documentation review and improvement for: Medical Necessity Level of Care Appropriateness of service and service location Billing documentation requirements and analysis of UB-04, Remittance Advices and Itemized Bills Assist with coding compliance reviews including professional, hospital outpatient, and inpatient hospital services Assist with regulatory compliance for Medicare, Medicaid, and third-party payers to include ambulatory, acute care (inpatient and...

Job Description Job Description POSITION DESCRIPTION PYA is seeking a Quality Assurance Nurse Auditor/Nurse Analyst/Coding Auditor to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will be a member of the Revenue and Compliance Advisory Team . For more information about PYA, please visit: www.pyapc.com RESPONSIBILITIES Provide advisory services to ambulatory care, acute care, and post-acute care organizations, including documentation review and improvement for: Medical Necessity Level of Care Appropriateness of service and service location Billing documentation requirements and analysis of UB-04, Remittance Advices and Itemized Bills Assist with coding compliance reviews including professional, hospital outpatient, and inpatient hospital services Assist with regulatory compliance for Medicare, Medicaid, and third-party payers to include ambulatory, acute care (inpatient and...

Job Description Job Description Why LexiCode? LexiCode is a leading healthcare solutions company specializing in medical coding and consulting services. With a commitment to accuracy, efficiency, and innovation, we provide comprehensive coding solutions to healthcare organizations across the nation. Our team is composed of highly skilled professionals who play a crucial role in ensuring accurate reimbursement and compliance within the healthcare industry. Fully remote, work from home opportunity! We’re looking for self-motivated coding professionals to join our remote coding services team. Elevate your career with LexiCode and uncover a wealth of benefits: · Lucrative compensation packages featuring top pay & performance-based incentives, ensuring your efforts are duly rewarded.· Enjoy ample leisure time with our generous paid time off, offering 23 days per year. · Receive personalized support from dedicated employee success managers who are invested in your...

Position Description: This position is responsible for reviewing, prioritizing, and analyzing adverse medical events related to medical devices that are submitted on MedWatch reporting forms via hard copy or electronically to our customer, the Food and Drug Administration (FDA). Additionally, this position is responsible for processing and coding a variety of reports from device manufacturers (MFR), importers, user facilities, health care professionals, and customers. While Analyst Coders may be assigned to perform the primary functions shown above, they will also be cross-trained to perform secondary duties according to business needs. Required Qualifications: Must Possess a Bachelor's degree in related health science fields such as nursing, pharmacy, veterinary, and/or certified licensed technicians as appropriate for each center. Good telephone etiquette. Clinical experience in the different medical specialties. Team player, good organizational skills, flexible, open to...

RN Compliance Auditor at Humana in Boise, Idaho, United States Job Description Become a part of our caring community and help us put health first The RN, Compliance Nurse 2, Quality Assurance Auditor reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The RN, Compliance Nurse 2, Quality Assurance Auditor ensures mandatory reporting is completed. Conducts and summarizes compliance audits. Collects and analyzes data daily, weekly, monthly or as needed to assess outcome and operational metrics for the team and individuals. + Perform pre-service denial and quality assurance audits and summarize findings for the clinical operational teams to initiate and identify needed corrective action plans + Makes necessary revisions and edits to member pre-service denial letters prior to mailing to ensure compliance with Medicare requirements + Analyze authorizations and medical...