- Novant Health (NC)
- …be limited to: coding audits, charge edit and denial audits, commercial payers, and CMS payers. Responses will be coordinated through the Audit Response Lead for all ... charging, clinical documentation improvement operations, accuracy and timeliness, unbilled claims management , claim edits and denial management . + The Corporate… more
- ASM Research, An Accenture Federal Services Company (Raleigh, NC)
- …are handled according to contractual service standards and document all cases in the Case Management System ( CMS ). + Performs call follow-up and reporting as ... Cyber Awareness and PII to ensure access to the CMS system is maintained. **Minimum Qualifications** +...to type 50 wpm + Excellent organization and time management skills + Comply with all HIPAA regulations +… more
- LifePoint Health (Rutherfordton, NC)
- …management and quality screening for assigned patients.7. Addresses/resolves system problems impeding diagnostic or treatment progress. Proactively identifies and ... Rutherford Regional Health System is a 143-bed acute care facility that...Accountable for the execution, adaptation and outcome of care management as prescribed in the initial Utilization Review Plan… more
- LifePoint Health (Henderson, NC)
- …the desired results of measure sets. Adheres to abstraction rules of CMS , TJC when performing chart abstractions for these entities. Performs clinical concurrent ... of the data, and adheres to abstraction rules of CMS , TJC, DLP Outcomes Measurement, and Ethics and compliance...and take appropriate action. *Minimum Work Experience* Knowledge of content of medical records and chart audits reviews. Excellent… more
- Prime Therapeutics (Raleigh, NC)
- …Operations **Job Description Summary** This position provides administrative oversight and management of rebate operations team and is responsible for directing day ... department. Solution issues and communicate issues and recommended solutions to upper management . Enforces teamwork across all internal departments, as well as with… more
- Arrow Electronics (Charlotte, NC)
- …Drive net new Commercial, Mid-Market, & Small & Medium size business ( CMS ) pipeline with DMP partners through demand generation, sales enablement, and services ... goal being to grow the DMP partner base across CMS , ASA, AFF, FAST quotes, & other strategic growth...to grow sales/market share with NetApp and conduct stakeholder management with key constituents in other departments to enable… more
- Deloitte (Charlotte, NC)
- …have any combination of Application Management Services (AMS), Infrastructure Management Services (IMS), Cloud Managed Services ( CMS ), or Business Process ... development and analyzing data to drive decisions + Knowledge of AMS/IMS/ CMS /BPaas solution tenets, estimation approaches, and solution integration + Top-notch… more
- Highmark Health (Raleigh, NC)
- …SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most current ... be required. The incumbent ensures compliance to NCQA, URAC, CMS , DOH, and DOL regulations at all times. In...member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more
- NASCO (Raleigh, NC)
- …enhance our industry leading SaaS healthcare payer products and corporate data management products. This hands-on leader will be responsible for actively leading and ... enable our customers. This leader will partner with key vendors/partners, product management , and our data engineering team to ensure effective data architecture and… more
- Ralliant (Raleigh, NC)
- …the design and integration of our digital ecosystem-spanning ecommerce, customer data, and content systems. This is a high-impact role where your work will directly ... and integrate digital platforms across Ecommerce, ERP, CRM, PIM, CMS , and customer data systems. + Lead the front-end...frameworks. + Build and maintain API connectors for dynamic content , product data, and backend systems. + Establish and… more