Role Description This position is located in the Health Information Management (HIM) section at the Kansas City VA Medical Center. MRTs (Coder) Auditors are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multi-specialty clinics, and specialty centers. These coding practitioners analyze and abstract patients' health records, and assign alpha-numeric codes for each diagnosis and procedure. - Duties consist of significant scope, complexity (difficulty), range of variety, and be performed by the incumbent at least 25% of the time. - Auditors must be able to perform all duties of a MRT (Coder). - Serve as experts of current coding conventions and guidelines related to professional and facility coding. - Perform audits of encounters to identify areas of non-compliance in coding. - Facilitate improved overall quality, completeness, and accuracy of coded data. - Provide recommendations on appropriate coding and maintain current knowledge of various regulatory guidelines and requirements. - Assist facility staff with documentation requirements to accurately reflect patient care provided. - Provide technical support in areas of regulations and policy, coding requirements, resident supervision, reimbursement, workload, accepted nomenclature, and proper sequencing. - Consult directly with clinical staff for clarification of conflicting or ambiguous clinical data. - Use computer applications to produce reports, abstract records, and review assigned codes. - Perform prospective and retrospective coding audits and utilize results to identify documentation and coding inadequacies. - Act independently to plan, organize, and perform auditing with emphasis on data validation, analysis, and report generation. - Assist in the development of guidelines for data quality, consistency, and monitoring for compliance. - Maintain statistical databases to track results and validate the program. - Identify patterns and variations in coding practices with regular reports to medical staff and management. Qualifications - United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. - Experience: One year of creditable experience that indicates knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding, and the structure and format of health records. - Education: An associate's degree from an accredited college or university recognized by the U.S. Department of Education with a major field of study in health information technology/health information management, or a related degree with a minimum of 12 semester hours in health information technology/health information management. - Completion of an AHIMA approved coding program, or other intense coding training program of approximately one year or more. - Equivalent combinations of creditable experience and education are qualifying for meeting the basic requirements. Requirements - Certification: Persons hired or reassigned to MRT (Coder) positions in the GS-0675 series in VHA must have either: - Apprentice/Associate Level Certification through AHIMA or AAPC. - Mastery Level Certification through AHIMA or AAPC. - Clinical Documentation Improvement Certification through AHIMA or ACDIS. - Grade Determinations: Medical Records Technician (Coder) Auditor, GS-9. - Experience: One year of creditable experience equivalent to the journey grade level of a MRT (Coder). - Certification: Employees at this level must have a mastery level certification. - Demonstrate all of the following KSAs: - Advanced knowledge of current coding classification systems such as ICD, CPT, and HCPCS. - Ability to research and solve complex questions related to coding conventions and guidelines. - Ability to review coded data and supporting documentation for adherence to standards. - Ability to format and present audit results, identify trends, and provide guidance. - Skill in interpersonal relations and conflict resolution. - Preferred Experience: Certified/Credentialed Coder with at least 3 years of coding and auditing experience. Benefits - Work Schedule: 7:30 AM to 4:00 PM Monday-Friday. - Telework: No, this is a remote position. - Virtual: This is a virtual position. - Relocation/Recruitment Incentives: Not Authorized. - Permanent Change of Station (PCS): Not Authorized. - PCS Appraised Value Offer (AVO): Not Authorized. Physical Requirements See VA Directive and Handbook 5019, Employee Occupational Health Service for requirements.

Title: Field Premium Auditor - Salt Lake County Location: Draper United States Job Description: A career at Auto-Owners is challenging and rewarding. Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Job Description We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated Field Premium Auditor to join our team. The position requires the person to: - Audit insured records to determine the proper exposure classifications and premium basis and provides reports and recommendations to Underwriting. - For assigned policies, determine the proper exposure classification, premium basis and scope of operations through the use of observation, discussion with insureds and the review of accounting records. - Report and discuss exposures present on an insured's property to determine underwriting eligibility and acceptability. - Communicate with claims and underwriting associates, appointed agents and insureds. - Make recommendations to Underwriting, as necessary, to terminate coverage based on observed exposure to loss. - Manage assigned territory by effectivity scheduling assigned audits to maximize the number of physical audits accurately completed. - Establish weekly agenda of scheduled appointments. Desired Skills & Experience - Bachelor's degree or equivalent experience. - Has completed or is in the process of completing the Associate in Premium Auditing (APA) designation. - These requirements may be waived or changed, at Company discretion, based on prior education and/or experience. - Ability to drive an automobile, possess a valid driver license and maintain a driving record consistent with the Company's underwriting guidelines for coverage. Benefits Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you! Equal Employment Opportunity Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law. - Please note that the ability to work in the U.S. without current or future sponsorship is a requirement. #LI-BK1 #LI-Hybrid

Role Description The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote position. Essential Functions & Responsibilities: - Collects supporting data and analyzes information to make decisions regarding accuracy of billing - Appropriately documents work and final conclusions in designated computer program - Understanding of Surgical Implants - Meets department's expectations and standards - Additional duties as assigned Qualifications - Understanding of Itemization Review for designated clients - Understanding of CERIS systems and Data Base informatics - Understanding of HIPAA regulations - Exceptional organizational skills with the ability to handle stressful situations and adapt accordingly - Demonstrated leadership skills; ability to work with Leadership Team(s) within a positive team environment - Strategic problem solving, analytical, and critical thinking skills - Effective written and verbal communication skills - Ability to work independently and within a team environment - Proficiency with Microsoft Office Suite, including Excel, Outlook, Teams Requirements - Must maintain current licensure as a Registered Nurse in the state of employment - Must have a minimum of 5 years’ experience in the O.R., ICU, or E.R. as an R.N. - Associate Degree in Nursing or higher - Experience in medical bill auditing preferred but not mandatory Benefits - Comprehensive benefits package for full-time regular employees - Medical (HDHP) w/Pharmacy - Dental - Vision - Long Term Disability - Health Savings Account - Flexible Spending Account Options - Life Insurance - Accident Insurance - Critical Illness Insurance - Pre-paid Legal Insurance - Parking and Transit FSA accounts - 401K - ROTH 401K - Paid time off Company Description CERIS, a division of CorVel Corporation, a certified Great Place to Work® Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

• Plan and conduct external audits for manufacturing auditing systems • Evaluate compliance against documented processes and identify nonconformities, risks and improvement opportunities • Produce clear, accurate audit reports and verify the effectiveness of corrective actions • Maintain audit schedules, records, and documentation in line with accreditation requirements • Champion a strong customer service and quality culture while ensuring compliance with SGS policies and integrity standards