- Datavant (Frankfort, KY)
- …educational and life experiences to realize our bold vision for healthcare. As an Auditor , HCC Risk Adjustment Coder, you will review medical records to identify and ... + Proficient in ICD-10 coding. + Experienced in HCC coding across Medicare , commercial, and Medicaid sectors. + In-depth knowledge of medical terminology,… more
- Highmark Health (Frankfort, KY)
- …system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare ... Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician coding and/or… more
- Humana (Frankfort, KY)
- …experience in revenue cycle management (related to billing, coding, collections for Medicare and Medicaid claims) + Experience with Auditing and monitoring of ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Molina Healthcare (Louisville, KY)
- …and procedures to ensure accuracy, completeness, and compliance with Centers for Medicare and Medicaid Services (CMS) regulations and guidelines of risk adjustment ... data * Understand and oversee RAPS and EDPS data transmission and assist in identification of issues that impact data integrity and accuracy * Identify opportunities for data mining to ensure data gaps are minimized * Apply best practices to ensure accuracy of… more
- Elevance Health (Louisville, KY)
- …member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services ... programs. The **Audit and Reimbursement II** will support our Medicare Administrative Contract (MAC) with the federal government (The...on cost report audits, may serve as an in-charge auditor on less complex audits Dependent upon experience, may… more
- Molina Healthcare (Lexington, KY)
- …quality member intervention initiatives including all lines of business ( Medicare , Marketplace, Medicaid) Executes health plan's member and community quality ... or Healthcare Administration + 1 year of experience in Medicare and in Medicaid managed care + Certified Professional...be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you… more
- Molina Healthcare (KY)
- …quality member intervention initiatives including all lines of business ( Medicare , Marketplace, Medicaid). Executes health plan's member and community quality ... skills. **PREFERRED QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with...be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you… more
- Highmark Health (Frankfort, KY)
- …of the Following)** + Certified Public Accountant (CPA) + Certified Internal Auditor (CIA) + Certified Fraud Examiner (CFE) + Certified in Healthcare Compliance ... and cross-functional strategy development. + Experience with managed care, Medicare and federal and/or state regulations, quality improvement and compliance… more