6 senior clinical compliance auditor jobs found in Flowood, MS

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

Welbehealth Pace Program 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 Oversee audits and...

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 Oversee audits and participate...

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...

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...