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Remote Internal Audit Risk Management Jobs in New Mexico

Novartis Pharmaceuticals Corporation

$108K - $201K/yr

LI:#Remote Internal job title: CRA II Location : Remote (Florida) Key responsibilities: Serves as the primary site manager for assigned clinical investigative sites (first point of contact between ...

Novartis

$108K - $201K/yr

LI:#Remote Internal job title: CRA II Location : Remote (Florida) Key responsibilities: Serves as the primary site manager for assigned clinical investigative sites (first point of contact between ...

Cardinal Health

$49.75 - $66.25/hr

Location - Open to candidates nationwide working in a fully remote capacity, with preference ... risk management frameworks. * Provide application security oversight for audits, regulatory ...

Cardinal Health

$67K - $96K/yr

Partner closely with internal Product and IT teams in managing the freight audit system to ensure ... Remote Candidates who are back-to-work, people with disabilities, without a college degree, and ...

SQA Services

Audit Service Delivery Lead

Albuquerque, NM · Remote

$55K - $70K/yr

... internal efficiencies. Annually, SQA performs over 2,000 audits, 3 million parts inspected at the ... Audits Assessments Supplier Desktop Evaluations Manage remote Service Delivery Coordination team ...

Cardinal Health

$27.40/hr

This position is central to managing and executing freight invoice audit and payment processes ... of internal pay equity. #LI-JB1 #LI-Remote Candidates who are back-to-work, people with ...

JLL

Construction Senior Project Manager

Moriarty, NM · Remote

$99K - $134K/yr

Develop risk management plans and lead project teams through established work authorization ... internal considerations. Location: Remote -Albuquerque, NM, Moriarty, NM, Rio Rancho, NM, Santa Fe ...

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Remote Internal Audit Risk Management information

What is the difference between Remote Internal Audit Risk Management vs Remote Compliance Analyst?

AspectRemote Internal Audit Risk ManagementRemote Compliance Analyst
CertificationsCPA, CIA, CISACCA, CRCM
Work EnvironmentAudit departments, risk management teamsRegulatory compliance departments, legal teams
Industry UsageFinance, banking, insuranceFinancial services, healthcare, banking
Primary FocusAssessing internal controls, risk mitigationEnsuring adherence to regulations, policies

Remote Internal Audit Risk Management professionals focus on evaluating internal controls and mitigating risks within organizations, often working closely with audit teams. In contrast, Remote Compliance Analysts concentrate on ensuring organizations adhere to legal and regulatory requirements. While both roles require understanding of industry standards and certifications, their core responsibilities differ, with internal audit emphasizing risk assessment and compliance analysis focusing on regulatory adherence.

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Remote Internal Audit Risk Management jobs near you
Remote Profee Multispecialty Coder

Remote Profee Multispecialty Coder

Presbyterian Healthcare Services

Santa Fe, NM • On-site, Remote

$24.27 - $37.07/hr

Full-time

Medical, Dental, Vision, Life

This job post has expired today. Applications are no longer accepted.

Presbyterian Healthcare Services rating

7.0

Company rating: 7.0 out of 10

Based on 162 frontline employees who took The Breakroom Quiz

416th of 890 rated healthcare providers

Job description

Location Address:
Remote OfficeSanta Fe, NM 87501
Compensation Pay Range:
Minimum Offer $24.27Maximum Offer $37.07Now Hiring: Remote Profee Multispecialty Coder
Summary:
Build your Career. Make a Difference. Presbyterian is hiring a skilled Remote Multispecialty Pro Fee Coder to join our team.Type of Opportunity: Full timeJob Exempt: NoJob is based: Remote Workers New MexicoWork Shift: Varied Days and Hours (United States of America)
Responsibilities:
Presbyterian is seeking a talented Multispecialty Pro Fee Coder
With 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. Works on special coding compliance related projects, develops and presents educational programs, disseminates information to PHS/PMG departments and develops educational tools used to maintain compliance with regulations. 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
Some key responsibilities include:
  • Liaison to the Manager, Information Services, Finance/Patient Financial Services, all hospitals, all PMG sites, PHP, Home Health, Albuquerque Ambulance, Compliance and all ancillary departments in addressing functional coding, auditing, compliance and training issues and problems. Interacts with all levels of management.esponsible for maintaining accurate, complete and timely documentation in either electronic or hard copy form
  • Must be able to adapt to frequently changing work priorities and schedules. Maintains and disseminates up-to-date technical knowledge of legal and regulatory information from all appropriate jurisdictions concerning the given business area. This includes but is not limited to all ICD-9, ICD-10, CPT-4, HCPCS and APC updates and changes
  • Researches coding, billing and charging compliance issues, recommends and implements corrective action plans that assure compliance with regulatory agencies where appropriate. Identifies risks, develops and follows up on action plans, identifies lost revenue opportunities and any overpayments due to errors in coding and/or documentation, and provides compliance education
  • Assists in the creation of the CDQA Annual Audit Work-plan by utilizing the OIG work plan, Medicare and Medicaid regulations, RAC and other audit agency focuses, as well as internal and external risk assessments
  • Regularly exercises independent judgment in determining the reliability of data reviewed; recommends changes in existing practices to gain or maintain compliant behavior. Keeps actively informed on the business climate of the healthcare industry
  • Responds to inquiries and requests daily regarding coding and auditing issues and problems and ad-hoc analysis for all PHS management

Qualifications:
  • High school diploma/GED required. Must possess at least one of the following license/certifications: RHIT, RHIA, CPC, CCS and a minimum of three (3) years experience in coding and/or auditing required.
  • Audit experience preferred. Excellent written and verbal communication skills.
  • Excellent written and verbal communication skills.
  • Detail and results oriented. Ability to work independently and make independent decisions. Medical terminology, ICD-9, CPT-4 and HCPCS knowledge required.
  • Must have a proficient knowledge of Medicare, Medicaid, and other third party payer documentation, coding, and billing regulations for service lines(s) assigned.
  • Must possess excellent organizational and planning skills, including the ability to prioritize multiple tasks and perform them both accurately and simultaneously.
  • Must possess computer skills, especially with Microsoft Word, PowerPoint, and Excel applications. Must be able to use the internet and other resource applications for research purposes and to provide documentation that supports regulations quoted in audits.
  • Must possess strong written and verbal communication skills in order to communicate in clear, concise terms to management at all levels, including the ability to articulate complex regulatory information in laymans terms.
  • Must possess a personal presence of a highly qualified professional that is characterized by a sense of honesty, integrity, and the ability to inspire and motivate others.

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services

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About Presbyterian Healthcare Services

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Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1,600 providers and nearly 4,700 nurses.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Albuquerque, NM, US

Year founded

1908

Social media

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