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BlueCross BlueShield of South Carolina
- Columbia, SC / Atlanta, GA / Burlington, VT / 48 more...
Responsible for the coordination and completion of the audit reviews, reviewing audit work papers and reports completed by department staff, distributing reports to management, coordinating auditor's assignments, mentoring and coaching department staff, and assisting the department manager with the direction of the workflow of various risk management activities and special projects. Description
Posted Today
BlueCross BlueShield of South Carolina
- Columbia, SC / Atlanta, GA / Burlington, VT / 48 more...
Responsible for the coordination and completion of the audit reviews, reviewing audit work papers and reports completed by department staff, distributing reports to management, coordinating auditor's assignments, mentoring and coaching department staff, and assisting the department manager with the direction of the workflow of various risk management activities and special projects. Description
Posted Today
Reviews medical documentation to perform a variety of coding validations for multiple lines of business under Medicare/TRICARE to determine accuracy of billing and payment. Reassigns and sequences diagnostic and procedural codes using universally recognized coding system as appropriate. Compiles and analyzes statistics to determine focus areas for targeted medical review activities where there is
Posted Today
As member of the senior management team, provides administrative oversight to the medical staff, analyzes medical review utilization data, researches new medical procedures or technology, and acts as a resource to providers and internal staff on issues concerning medical policies. May also write and revise medical policies. Description This position can be worked remotely. Must be willing to tra
Posted Today
BlueCross BlueShield of South Carolina
- Charleston, SC / Atlanta, GA / Burlington, VT / 47 more...
Involved in all aspects of the Molecular Diagnostic Program (MoIDX) laboratory operations and serves as an internal subject matter expert, applying medical knowledge to advise decisionmakers in support of MoIDX's mission. Responsible for review and approval of documentation and reports, supporting clinical testing strategies, as well as new assay development and validation. Serves as an ambassador
Posted Today
BlueCross BlueShield of South Carolina
- Columbia, SC / Atlanta, GA / Burlington, VT / 48 more...
Description 20% Leads planning and implementation of projects to include coordinating the development and implementation of project and procedural enhancements, data gathering, process analyses, procedural documentation, leading development teams, training management and non management staff, and establishing processes to monitor and sustain effective changes. 20% Facilitates the definition of pr
Posted Today
THIS POSITION MAY BE WORKED FROM HOME IN ANY STATE. Responsible for providing a full range of financial, compliance, and operational audits, business advisory, and consultation services, investigations, internal controls, accountability, and use of resources. Description 50% Conducts internal and/or external timely operational, financial, and/or compliance audits of divisions, departments, provi
Posted Today
BlueCross BlueShield of South Carolina
- Springfield, IL / Columbia, SC / Charleston, SC / 1 more...
Responsible for providing a full range of financial, compliance, and operational audits, business advisory, and consultation services, investigations, internal controls, accountability, and use of resources. Description 50% Conducts internal and/or external timely operational, financial, and/or compliance audits of divisions, departments, providers, and activities of the corporation including ev
Posted Today
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