- Dignity Health (Bakersfield, CA)
- …errors. The Recovery Manager works in close coordination with internal audit , provider dispute resolution, and finance to maximize cost recovery , reduce ... or GED + Minimum 5 years of progressive experience in healthcare claims recovery , payment integrity, or post-payment audit functions, preferably within a… more
- Stanford Health Care (Palo Alto, CA)
- …complete and accurate capture of all legitimate reimbursement opportunities. + Oversee Medicare and Medi-Cal audit processes, addressing inquiries and pursuing ... and regulatory reports to government agencies, including but not limited to: * Medicare and Medi-Cal cost reports *Financial disclosures to the Department of Health… more
- Stanford Health Care (Palo Alto, CA)
- …billing, including federal and state regulations and guidelines, CMS (Centers for Medicare and Medicaid Services) and OIG (Office of Inspector General) compliance ... + Conducts defensive charge audits, self-pay/patient requests, or other special audit projects, as requested, comparing itemized bills to corresponding medical… more
- TEKsystems (Martinez, CA)
- …adjudication, payment integrity, regulatory compliance, and vendor oversight across Medi-Cal, Medicare , and commercial lines of business. This role ensures claims ... responsibility for complex, high-volume systems * Knowledgeable in Medicaid and Medicare : Demonstrates deep understanding of Medi-Cal and Medicare program… more
- The County of Los Angeles (Los Angeles, CA)
- …rules and regulations and result in maximum revenue collection. Prepares Medicare and Medi-Cal cost reports and State mandated disclosure reports. Analyzes ... and adjusts billing rates to reflect cost changes and maximize cost recovery . Analyzes utilization of billing rates and/or contract allocations for appropriate… more
- The County of Los Angeles (Los Angeles, CA)
- …rules and regulations and result in maximum revenue collection. + Prepares Medicare and Medi-Cal cost reports and State mandated disclosure reports. + Analyzes ... billing rates to reflect cost changes and maximize cost recovery . + Analyzes utilization of billing rates and/or contract...manuals pertinent to accounting control, fiscal record keeping and audit trails. + Reviews, analyzes and drafts replies to… more
- The County of Los Angeles (Los Angeles, CA)
- …procedures concerning program administration, ensuring compliance with Federal and State Medicare and Medicaid regulations for reimbursement claiming and maximum ... recovery costs for directly operated billable services. Develops and...methods as necessary. Oversees audits and the implementation of audit recommendations for programs managed. Represents managed programs in… more