- New York State Civil Service (Albany, NY)
- …& Payment Oversight. Duties include but are not limited to:-Collaborate closely with the Recovery Audit Contractor ( RAC ) to facilitate reviews through ... the new Draft Audit Report (DAR) and Final Audit Report (FAR) procedures.-Contacting appropriate internal OMIG stakeholders and external stakeholders for… more
- Elderwood (Buffalo, NY)
- …and integrity of clinical reimbursement data and billing processes. + Audit MDS coding and supporting documentation; identify opportunities for improvement. + ... the Elderwood network. What We're Looking For: + Active RN license (required). + RAC -CT certification preferred. + Minimum of 5 years of MDS experience in a skilled… more
- Highmark Health (Albany, NY)
- …entities in response to external coding audits conducted by the Medicare Administrative Contractor , the RAC , MIC, ZPIC, etc. Determine appeal action, prepare ... OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and… more
- St. John's Embrace Living (Rochester, NY)
- …payer audits. This includes but is not limited to Department of Health Survey, PRI Audit , OMIG Audits, Third Party/HMO Audits, RAC and MAC reviews + Assure all ... guidance regarding the delivery of liability notices is maintained. Update process and educate staff when process is changed + Assist medical records coding of ICD-10 codes + Submit PBJ data through QIES + Provide education to the interdisciplinary staff… more
- Mohawk Valley Health System (Utica, NY)
- …+ Provide peer-to-peer payor review in collaboration with attending physicians. + Support Recovery Audit Contractors ( RAC 's). + Assist with mitigating ... barriers to discharge and care progression. + Perform concurrent review of cases greater than 4 days or the assigned/estimated GMLOS + Partner with the care management team with the management of LOS, complex care needs and patient throughput efforts. Provide… more
- Mohawk Valley Health System (Utica, NY)
- …procedure codes, for accurate and timely billing of most appropriate payer + Audit charges and establish proper coding in collaboration with providers + Initiate and ... departments with diagnostic and procedural coding + Respond to Insurance, compliance and RAC denials + Review and assist in the maintenance of coding related… more
- Wolters Kluwer (New York, NY)
- …Important responsibilities include cross-functional correspondence, quality management reviews, audit support, change planning, and corrective and preventative ... future issues . Lead Auditor Certified, preferred . Regulatory Affairs Certification ( RAC ), preferred. **TRAVEL:** Travel is minimal and tends to be irregular in… more