Medical Billing Specialist JobotMedical Billing SpecialistAlbuquerque, NM$18–$25 / hourInformation collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from Jobot, and/or its agents and contracted partners.
Medical Biller JobotMedical BillerAlbuquerque, NM$18–$22 / hourInformation collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from Jobot, and/or its agents and contracted partners.
Dental Assistant JobotDental AssistantAlbuquerque, NM$17–$20 / hourInformation collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. This is an excellent opportunity for a seasoned dental assistant looking to expand their skill set and take on a new challenge in a fast-paced, rewarding environment.
RN Clinical Supervisor - Acute Orthopedics CHRISTUS HealthRN Clinical Supervisor - Acute OrthopedicsSanta Fe, NMAssists with new associate selection and unit education-participating in staff interviews, setting clear staff performance expectations, encouraging staff development, and completing timely performance evaluations-including staff input in each process. The Clinical Supervisor, in collaboration with and under the direction of the Nursing Department Director/Manager, is accountable for ongoing shift leadership and operations of a clinical department and for nursing care safety and quality.
NewRN, Clinical Supervisor - Acute Psych Adult CHRISTUS HealthRN, Clinical Supervisor - Acute Psych AdultSanta Fe, NMAssists with new associate selection and unit education-participating in staff interviews, setting clear staff performance expectations, encouraging staff development, and completing timely performance evaluations-including staff input in each process. The Clinical Supervisor, in collaboration with and under the direction of the Nursing Department Director/Manager, is accountable for ongoing shift leadership and operations of a clinical department and for nursing care safety and quality.
NewRN, Clinical Supervisor - Acute Oncology - PRN CHRISTUS HealthRN, Clinical Supervisor - Acute Oncology - PRNSanta Fe, NMAssists with new associate selection and unit education-participating in staff interviews, setting clear staff performance expectations, encouraging staff development, and completing timely performance evaluations-including staff input in each process. The Clinical Supervisor, in collaboration with and under the direction of the Nursing Department Director/Manager, is accountable for ongoing shift leadership and operations of a clinical department and for nursing care safety and quality.
NewRN, Clinical Supervisor - Nursing Float Pool CHRISTUS HealthRN, Clinical Supervisor - Nursing Float PoolSanta Fe, NMAssists with new associate selection and unit education-participating in staff interviews, setting clear staff performance expectations, encouraging staff development, and completing timely performance evaluations-including staff input in each process. The Clinical Supervisor, in collaboration with and under the direction of the Nursing Department Director/Manager, is accountable for ongoing shift leadership and operations of a clinical department and for nursing care safety and quality.
NewRN, Clinical Supervisor - Acute MedSurgical A CHRISTUS HealthRN, Clinical Supervisor - Acute MedSurgical ASanta Fe, NMAssists with new associate selection and unit education-participating in staff interviews, setting clear staff performance expectations, encouraging staff development, and completing timely performance evaluations-including staff input in each process. The Clinical Supervisor, in collaboration with and under the direction of the Nursing Department Director/Manager, is accountable for ongoing shift leadership and operations of a clinical department and for nursing care safety and quality.
NewRN, Clinical Supervisor - Acute MedSurgical B CHRISTUS HealthRN, Clinical Supervisor - Acute MedSurgical BSanta Fe, NMAssists with new associate selection and unit education-participating in staff interviews, setting clear staff performance expectations, encouraging staff development, and completing timely performance evaluations-including staff input in each process. The Clinical Supervisor, in collaboration with and under the direction of the Nursing Department Director/Manager, is accountable for ongoing shift leadership and operations of a clinical department and for nursing care safety and quality.
NewRN, Clinical Supervisor CSV - Acute Oncology CHRISTUS HealthRN, Clinical Supervisor CSV - Acute OncologySanta Fe, NMAssists with new associate selection and unit education-participating in staff interviews, setting clear staff performance expectations, encouraging staff development, and completing timely performance evaluations-including staff input in each process. The Clinical Supervisor, in collaboration with and under the direction of the Nursing Department Director/Manager, is accountable for ongoing shift leadership and operations of a clinical department and for nursing care safety and quality.
NewRN Clinical Supervisor - Pain Management CHRISTUS HealthRN Clinical Supervisor - Pain ManagementSanta Fe, NMAssists with new associate selection and unit education-participating in staff interviews, setting clear staff performance expectations, encouraging staff development, and completing timely performance evaluations-including staff input in each process. The Clinical Supervisor, in collaboration with and under the direction of the Nursing Department Director/Manager, is accountable for ongoing shift leadership and operations of a clinical department and for nursing care safety and quality.
NewRN Clinical Supervisor - Cardiology Cath CHRISTUS HealthRN Clinical Supervisor - Cardiology CathSanta Fe, NMAssists with new associate selection and unit education-participating in staff interviews, setting clear staff performance expectations, encouraging staff development, and completing timely performance evaluations-including staff input in each process. The Clinical Supervisor, in collaboration with and under the direction of the Nursing Department Director/Manager, is accountable for ongoing shift leadership and operations of a clinical department and for nursing care safety and quality.
NewManager Practice II - Primary Family Medicine CHRISTUS HealthManager Practice II - Primary Family MedicineAlbuquerque, NMManages subordinate personnel, prepares clinic budget, ensures data accuracy, prepares financial analyses, handles customer service issues and maintains provider/staff communications. Works closely with leadership to develop, implement, and maintain programs that enhance quality of care and achieve a high level of patient and provider satisfaction as well as meeting budgeted financial clinic performance.
NewTravel Outpatient Physical Therapist - $2,132 per week American TravelerTravel Outpatient Physical Therapist - $2,132 per weekTaos, NMAmerican Traveler is seeking a licensed Physical Therapist for an outpatient position in Taos, NM, requiring at least 1 year of outpatient experience with a NM state license required prior to start. Role includes performing WorkSTEPS, APET, Work Hardening Evaluations, Functional Capacity Evaluations, ergonomic evaluations, and job analyses.
NewTravel Physical Therapist - Home Health - $2,326 per week Prime StaffingTravel Physical Therapist - Home Health - $2,326 per weekAlbuquerque, NMPrime Staffing utilizes a unique matchmaking approach, providing the most qualified contingent staffing to our clients, and the most competitive contracts to our workforce. Pay package is based on 12 hour shifts and 36.0 hours per week (subject to confirmation) with tax-free stipend amount to be determined.
NewCoordinator Pharmacy 340B Program - General Pharmacy CHRISTUS HealthCoordinator Pharmacy 340B Program - General PharmacySanta Fe, NMThe 340B Compliance Coordinator will synthesize and analyze all data related to participation in the Program including performing routine audits, maintaining policies, procedures, and annual re-certification, and is responsible for day-to-day administration and operation of the Program. Potential for exposure to hazardous and toxic substances (including chemotherapeutic, cytotoxic drugs and cleaning solutions), sticks or cuts by needles and other sharp items.
Medical Coding Auditor - Must have a NM Residence UNM Medical Group IncMedical Coding Auditor - Must have a NM ResidenceAlbuquerque, NMDuties and Responsibilities of a Medical Coding Analyst: Audits medical record documentation to identify undercoded and overcoded services, prepares reports and observations and meets with providers, support staff and coding personnel to provide education and training on accurate documentation and coding practices in compliance with regulatory requirements. Assists management in the review of external payer requests including but not limited to third party payers, Medicare Advantage plans, and Recovery Audit Contractor reviews for reconsideration, appeal and rebuttal actions.
Medical Coding Auditor - Must have a NM Residence UNM Medical Group, Inc.Medical Coding Auditor - Must have a NM ResidenceAlbuquerque, NMAudits medical record documentation to identify undercoded and overcoded services, prepares reports and observations and meets with providers, support staff and coding personnel to provide education and training on accurate documentation and coding practices in compliance with regulatory requirements. Assists management in the review of external payer requests including but not limited to third party payers, Medicare Advantage plans, and Recovery Audit Contractor reviews for reconsideration, appeal and rebuttal actions.
Medical Coding Analyst I or II - Must have a NM Residence UNM Medical Group, Inc.Medical Coding Analyst I or II - Must have a NM ResidenceAlbuquerque, NMRemoteReviews and analyzes medical records in order to assign appropriate CPT and ICD-10 codes for inpatient and outpatient consultations, procedures, anesthesia, inpatient visits, and office visits for new or established patients. Responsible for coding Inpatient/Outpatient charges and specialty services using appropriate ICD and CPT classification systems for the purpose of reimbursement, research and compliance in accordance with federal regulation.
Medical Coding Analyst I or II - Must have a NM Residence UNM Medical Group IncMedical Coding Analyst I or II - Must have a NM ResidenceAlbuquerque, NMRemoteReviews and analyzes medical records in order to assign appropriate CPT and ICD-10 codes for inpatient and outpatient consultations, procedures, anesthesia, inpatient visits, and office visits for new or established patients. Responsible for coding Inpatient/Outpatient charges and specialty services using appropriate ICD and CPT classification systems for the purpose of reimbursement, research and compliance in accordance with federal regulation.
Medical Coding Supervisor - Must have a NM Residence UNM Medical Group, Inc.Medical Coding Supervisor - Must have a NM ResidenceAlbuquerque, NMRemote3. Provides ongoing training and education to staff on new department policies, coding rule changes, and updated payer requirements; ensures that the coding team is current on coding and billing. Provides feedback to providers regarding results and findings from billing/coding reviews/audits, medical records documentation deficiencies, and/or requests clarification of documentation.
Medical Coding Supervisor UNM Medical Group IncMedical Coding SupervisorAlbuquerque, NMRemoteProvides ongoing training and education to staff on new department policies, coding rule changes, and updated payer requirements; ensures that the coding team is current on coding and billing. Provides feedback to providers regarding results and findings from billing/coding reviews/audits, medical records documentation deficiencies, and/or requests clarification of documentation.
Coding Quality Educator - Remote Providence Health & ServicesCoding Quality Educator - RemoteNMRemoteRequsition ID: 443735 Company: Providence Jobs Job Category: Coding Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Multiple shifts available Career Track: Business Professional Department: 4010 SS PE OPTIM Address: WA Renton 1801 Lind Ave SW Work Location: Providence Valley Office Park-Renton Workplace Type: On-site Pay Range: $See Posting - $See Posting The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
Coding Quality Educator - Remote Providence St. Joseph HealthCoding Quality Educator - RemoteAlbuquerque, NMRemoteTogether, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. This position will assist with new employee training and ongoing department education as well as assist with the identification, development and delivery of new and ongoing provider education and training related to coding and clinical documentation.
Bilingual Medical Office Administrator with billing experience Muojicare Medical Center LlcBilingual Medical Office Administrator with billing experienceLas cruces, NM$13–$18 / hourPosition Overview: The Medical Office Manager will be responsible for managing administrative operations, coordinating patient flow, and assisting with clinical support when needed. About Us: Muojicare Medical Center is a patient-focused healthcare practice dedicated to delivering high-quality care in a compassionate and efficient environment.
Entry Level Medical Billing Assistant Revel StaffingEntry Level Medical Billing AssistantAlbuquerque, New MexicoThe Medical Billing Assistant will help prepare and review insurance claims, assist with basic billing and coding tasks, update patient and insurance information, and support the administrative workflows that help keep clinical operations running smoothly. This person should be comfortable learning billing and coding processes, communicating with patients professionally, and maintaining accuracy when working with claims, records, and confidential information.
Billing Research Specialist - Journal Center, (946) TriCore Reference LaboratoriesBilling Research Specialist - Journal Center, (946)Albuquerque, NMESSENTIAL FUNCTIONS: Performs billing research functions and problem solving activities utilizing internal computer systems and Internet sites as appropriate by locating missing requisitions, status inquiries for patient/client accounts, calling on problems, verifies insurance and diagnosis information, and resolving discrepancies. Enters billing information into billing system and other Business Office applications for scrubber edits (i.e. Rhodes Fusion Scrubber, Antrim, Fast Orders etc.) as appropriate.
Billing Research Specialist-Journal Center, (1456) TriCore Reference LaboratoriesBilling Research Specialist-Journal Center, (1456)Albuquerque, NMESSENTIAL FUNCTIONS: Performs billing research functions and problem solving activities utilizing internal computer systems and Internet sites as appropriate by locating missing requisitions, status inquiries for patient/client accounts, calling on problems, verifies insurance and diagnosis information, and resolving discrepancies. Enters billing information into billing system and other Business Office applications for scrubber edits (i.e. Rhodes Fusion Scrubber, Antrim, Fast Orders etc.) as appropriate.
Outpatient Coder - Coding CHRISTUS HealthOutpatient Coder - CodingAlamogordo, NMThe coder will accurately abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM Guidelines for Coding and Reporting and CPT Guidelines. Coder will work collaboratively with various CHRISTUS Health departments (Admitting, Charging, Patient Financial Services, HIM, etc.) to resolve charging issues, denials, and physician documentation clarifications, to ensure accurate billing and reduce denials.
NewHealth Information Management Coder Lead - Coding CHRISTUS HealthHealth Information Management Coder Lead - CodingSanta Fe, NMCoding Lead will work with Coders as a resource to maintain current and high-quality ICD-10-CM, ICD-10-PCS and/or CPT coding for the Inpatient and/or Outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. Coding Leads will work to ensure Coders abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM and ICD-10-PCS Guidelines for Coding and Reporting and AMA CPT Guidelines.
Dental Coding Analyst UNM Medical Group, Inc.Dental Coding AnalystAlbuquerque, NMThe Dental Billing Analyst promotes a positive patient experience through clear, respectful communication and high-quality customer service while supporting organizational revenue. The is seeking a highly motivated individual to work as a Dental Coding Analyst in our Division of Dental Services Residency Clinic.
Dental Coding Analyst UNM Medical Group IncDental Coding AnalystAlbuquerque, NMThe Dental Billing Analyst promotes a positive patient experience through clear, respectful communication and high-quality customer service while supporting organizational revenue. The is seeking a highly motivated individual to work as a Dental Coding Analyst in our Division of Dental Services Residency Clinic.
Med Coding Analyst University of New MexicoMed Coding AnalystAlbuquerque, NMThe University of New Mexico Student Health & Counseling clinic (SHAC) is recruiting for a knowledgeable, detail-oriented Medical Coding Analyst to coordinate the processing of fees for professional services provided to patients within a specified group of clinical areas, for the purpose of reimbursement. This position analyzes patient medical records to assure that documentation by providers conforms to legal and procedural requirements and assigns specified codes to medical diagnoses and/or clinical procedures.
Billing Specialist El Centro Family HealthBilling SpecialistEspañola, NMFull timePosition Overview: Under the direction of the Chief Financial Officer (CFO), the Billing Specialist collaborates with the External Billing Consultant and CFO, as needed, to carry out various clerical tasks related to maintaining clinic patient accounts. As a Federally Qualified Health Center (FQHC) and 501(c)(3) nonprofit, El Centro Family Health is dedicated to providing affordable, accessible, and high-quality healthcare to the people of Northern New Mexico.
NewCoding Data Quality Auditor CVS Health CorpCoding Data Quality AuditorNM$18.50–$38.82 / hourResponsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures. Proficient in abstraction and assignment of accurate medical codes for diagnoses as documented by physicians and other qualified healthcare providers in the office and/or facility setting.
NewRemote IP Facility Coder with CCS - Medical Records Presbyterian System ServicesRemote IP Facility Coder with CCS - Medical RecordsNew MexicoRemoteThe IP Facility Coder has the knowledge and ability and will be required to code all of the following: inpatient and/or outpatient hospital records, ED records, Home Health & Hospice records and/or professional fee services for PMG specialty providers or demonstrate coding expertise in a specific specialty deemed a critical business need by PHS Coding Leadership using the ICD-9/10 CM and CPT-4 classification system. Reviews patients entire current medical record, assigning appropriate codes including CPT, ICD and MS-DRG (as defined by UHDDS guidelines and CMS) to be used for financial reimbursement, research in accordance with Federal Regulations and Hospital and Departmental policies.
IP Facility Coder with CCS - Medical Records Presbyterian Healthcare ServicesIP Facility Coder with CCS - Medical RecordsNMThe IP Facility Coder has the knowledge and ability and will be required to code all of the following: inpatient and/or outpatient hospital records, ED records, Home Health & Hospice records and/or professional fee services for PMG specialty providers or demonstrate coding expertise in a specific specialty deemed a critical business need by PHS Coding Leadership using the ICD-9/10 CM and CPT-4 classification system. Reviews patients entire current medical record, assigning appropriate codes including CPT, ICD and MS-DRG (as defined by UHDDS guidelines and CMS) to be used for financial reimbursement, research in accordance with Federal Regulations and Hospital and Departmental policies.
Medical Assistant Laguna Community Health CenterMedical AssistantParaje, New MexicoPrepare treatment rooms for patient examinations, keeping rooms neat and clean; discarding waste, needles and other biohazard waste according to established protocols, Greet and log in patients arriving at office or clinic. 3. Knowledge of terminology and skills sufficient to report the patient's physical and emotional reactions for the purpose of effective communication with nursing and medical personnel and for recording and reporting pertinent information for inclusion in patient care plans.
Medical Coder (Inpatient Rehab) Remote ClearSky HealthMedical Coder (Inpatient Rehab) RemoteAlbuquerque, New MexicoRemoteCurrent knowledge of CPT and ICD-10 coding principles, government regulations, protocols, and third party payer requirements regarding coding and billing. The Medical Coder reviews and assigns diagnostic and procedure codes to patient records for reimbursement and data purposes, in keeping with state and federal regulations.
Medical Assistant I First Choice Community Health CentersMedical Assistant IAlbuquerque, NMUnder the supervision of the Nurse Flow Manager within the Health Center, the Medical Assistant I functions at the entry level of a Medical Assistant in clinical and clerical support as part of a patient care team of providers and nurses who provide direct patient care at the health centers. Administration of medication through inhalation, ears, eyes, orally and by injection after required trainings have been completed and having been observed and signed off by a provider or licensed health professional.
Medical Assistant First Choice Community Health CentersMedical AssistantAlbuquerque, NMUnder the supervision of the Nurse Flow Manager within the Health Center, the Medical Assistant I functions at the entry level of a Medical Assistant in clinical and clerical support as part of a patient care team of providers and nurses who provide direct patient care at the health centers. Administration of medication through inhalation, ears, eyes, orally and by injection after required trainings have been completed and having been observed and signed off by a provider or licensed health professional.
Medical Practice Specialist University of New MexicoMedical Practice SpecialistAlbuquerque, NMThe Department of Neurosurgery values professional development and continuing education and in this spirit will support this position obtaining professional certification(s) such as the American College of Medical Practice Executive (ACMPE) or a Professional Coding Certification such as the American Academy of Professional Coders (AAPC). Duties for this position include but are not limited to: Oversee and evaluate the department's productivity and billing operations, while working with the department administration, the department leadership, UNMMG and UH to ensure compliance with appropriate procedures and applicable laws, regulations and policies.
Medical Group Clerical Specialist Presbyterian Healthcare ServicesMedical Group Clerical SpecialistNMSummary: Coordinates the encounter or appointment closure process for the customer/patient including advanced scheduling, co-pay collection, financial arrangements, coordination of service and preparation of a claim or account for billing in a specialty setting. Maintains supplies and equipment for department, Maintains and fosters effective customer relations with patients, providers and the public by listening, responding, and documenting customer phone and walk-in inquiries and complaints.
NewMedical Economics Analyst-Payment Integrity PHP AdministrativeMedical Economics Analyst-Payment IntegrityNew MexicoThe Payment Integrity Medical Economics Analyst plays a critical role in identifying, quantifying, and validating medical cost savings opportunities through deep partnership with the Payment Integrity team. This role combines advanced analytics, claims validation, and financial insight to ensure accuracy of payments, integrity of savings initiatives, and alignment to total cost of care (TCOC) objectives.
Medical Economics Analyst-Payment Integrity Presbyterian Healthcare ServicesMedical Economics Analyst-Payment IntegrityNMResponsibilities: The Payment Integrity Medical Economics Analyst plays a critical role in identifying, quantifying, and validating medical cost savings opportunities through deep partnership with the Payment Integrity team. This role combines advanced analytics, claims validation, and financial insight to ensure accuracy of payments, integrity of savings initiatives, and alignment to total cost of care (TCOC) objectives.
NewRN (CDI) Clinical Documentation and Compliance Specialist Presbyterian System ServicesRN (CDI) Clinical Documentation and Compliance SpecialistAlbuquerque, New MexicoActs as expert clinical resource for the HIM Coding team, working collaboratively to identify areas for clarification of documentation in the medical record that meets regulatory requirements to accurately reflect patient severity of illness and services provided. Works collaboratively with the Medical Staff, Nursing Staff and other patient care givers to improve the quality of chart documentation to accurately reflect services provided and present an accurate hospital and physicians profile.
NewRN (CDI) Clinical Documentation and Compliance Specialist Presbyterian Healthcare ServicesRN (CDI) Clinical Documentation and Compliance SpecialistNMActs as expert clinical resource for the HIM Coding team, working collaboratively to identify areas for clarification of documentation in the medical record that meets regulatory requirements to accurately reflect patient severity of illness and services provided. Works collaboratively with the Medical Staff, Nursing Staff and other patient care givers to improve the quality of chart documentation to accurately reflect services provided and present an accurate hospital and physicians profile.
RN Inpatient Pediatrics / Medical Surgical LanceSoft IncRN Inpatient Pediatrics / Medical SurgicalShiprock, NMThe RN Inpatient Pediatrics / Medical Surgical will provide comprehensive inpatient care to pediatric and med-surg patients in a hospital setting. The role requires strong clinical skills, emergency response capability, and the ability to work in a fast-paced, patient-centered environment.
NewRemote Pro Fee Auditor/Educator Presbyterian System ServicesRemote Pro Fee Auditor/EducatorNew MexicoRemoteWith minimal supervision directly supports the following responsibilities of the Coding and documentation quality assurance (CDQA) team: implementation of and compliance to enterprise-wide and department coding policies and procedures for PHS; compliance to all external regulatory agency coding rules and regulations; Demonstrates high-level of proficiency in performing and/or managing on-site internal audits or reviews to assess compliance/quality monitoring performed by PHS/PMG departments while serving as a resource on documentation, coding, billing, and coding compliance questions. Provides support via auditing and training the enterprise-wide corrective action plans for coding, audit , physician and clinician personnel identified as low performers; perform medical record and billing reviews of denied and appealed claims and takes appropriate action to ensure accurate payment of claims; coordinate review and tracking of appealed claims including the communication process with affected payers; research and interpret all regulatory agency regulations.
NewRemote IP Facility Coder with CCS Presbyterian System ServicesRemote IP Facility Coder with CCSNew MexicoRemoteWith minimal supervision directly supports the following responsibilities of the Coding and documentation quality assurance (CDQA) team: implementation of and compliance to enterprise-wide and department coding policies and procedures for PHS; compliance to all external regulatory agency coding rules and regulations; Demonstrates high-level of proficiency in performing and/or managing on-site internal audits or reviews to assess compliance/quality monitoring performed by PHS/PMG departments while serving as a resource on documentation, coding, billing, and coding compliance questions. Provides support via auditing and training the enterprise-wide corrective action plans for coding, audit , physician and clinician personnel identified as low performers; perform medical record and billing reviews of denied and appealed claims and takes appropriate action to ensure accurate payment of claims; coordinate review and tracking of appealed claims including the communication process with affected payers; research and interpret all regulatory agency regulations.