- Centene Corporation (Jefferson City, MO)
- …periodic reports and, as necessary, findings and conclusions for Human Resources, Internal Audit , Legal, the senior management team and the Board Compliance ... state regulators, including the OIG and the Centers for Medicare and Medicaid Services ("CMS"). + Oversees the management...as necessary, findings and conclusions for Human Resources, Internal Audit , Legal, the senior management team and… more
- Baylor Scott & White Health (Phoenix, AZ)
- …and senior medical staff including denials from all payers, Medicare /Medicaid audit activities and key contract enforcement activities. + Collaborates ... hospital and professional clinical and coding denials, as well as Recovery Audit Contractors (RAC) denials. This role will be responsible for developing and… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Your Responsibilities * Performs risk score computation and forecasting for Medicare , ACA, and Medicaid. * Oversees diagnostic coding gap identification ... * Tracks and evaluates risk adjustment initiatives performance across Medicare , ACA, and Medicaid throughout the year. * Identifies...to track and report provider performance metrics. * Provides audit support for RADV, OIG, and other regulatory or… more
- Cornerstone Caregiving (Waco, TX)
- …and DutiesRevenue Strategy & Optimization + Oversee all payer relationships, reimbursement cycles, and revenue processes for VA, Medicaid, LTCI, work comp, ... and Medicare programs. + Ensure billing and payment compliance with...for revenue management across all payer types. + Develop audit -ready documentation and internal controls around contractual billing and… more
- University of Southern California (Los Angeles, CA)
- …of audit responses, overlap resolution, and documentation requests from Medicare Administrative Contractors (MAC). + Monitor CMS GME affiliation agreements and ... Analyst provides essential analytical, operational, and administrative support to the Senior Project Manager for GME Finance in the coordination, management, and… more
- Centene Corporation (Springfield, IL)
- …and service delivery areas. + Oversee the accurate and timely submission of all CMS Medicare SNP requirements. + Serve as senior leadership and single point of ... audit processes. + Managing all facets of the audit and communications. + Serve as senior ...pay, health insurance, 401K and stock purchase plans, tuition reimbursement , paid time off plus holidays, and a flexible… more
- Primary Health Care (Des Moines, IA)
- …Directors as needed with training for existing staff. + Builds an audit process to ensure staff are accurately following established workflows. Conducts regular ... audits and collaborates with Clinic Directors to address audit results. + Builds and maintains customer service expectations during the registration process. +… more
- CommonSpirit Health (Burlington, CO)
- …Access Hospital and Rural Health Clinic conditions of participation and reimbursement , EMTALA, Medicare fraud and abuse, Stark/Antitrust legislation, and ... Finance Officer is primarily responsible for serving as the senior financial leader for Kit Carson County Memorial Hospital,...+ Contractual allowances and bad debt allowances + Annual audit preparation and support + Banking relations + Cost… more
- Novo Nordisk (Plainsboro, NJ)
- …forecast gross to net components including but not limited to Managed Care, and Medicare Part D, Medicaid as well as current and future Healthcare Reform related ... Finance + Responsible for ensuring that all rebate controls meet all audit and internal control (Sarbox) requirements Physical Requirements 0-10% overnight travel… more
- OhioHealth (Marion, OH)
- …other key stakeholders. Assist in analysis and coordination of amendments, reimbursement , and contractual language changes. Interacts closley with executive team and ... templates, forms, guidelines, procedures, executive and associate user guides, audit materials/checklists, etc. for cross-campus physician contract compliance use.… more