- Humana (Providence, RI)
- …standards and mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance, by ensuring compliance with governmental ... cycle management (related to billing, coding, collections for Medicare and Medicaid claims ) + Experience with Auditing and monitoring of healthcare records + Must… more
- McLaren Health Care (Shelby Township, MI)
- …of patient care and appropriately assign codes and/or determine charges to support those services. **Essential Functions and Responsibilities As Assigned** **:** 1. ... and efficiency in physician documentation, code assignment, data collection, and claims processing. 3. Performs retrospective, random, and focused audits of coding… more
- Lineage Logistics (Conklin, NY)
- …compliance with internal standards. + Identify and report discrepancies, damages, or claims to inventory control for resolution. + Organize and stock materials ... efficiently in designated warehouse locations to support assembly or shipping operations. + Operate warehouse equipment and material handling tools safely and… more
- City of New York (New York, NY)
- …reports. - Participates in and reviews the processing of fiscal documents, claims , financial statements, and the accounting for the receipt, deposit and disbursement ... managerial lump sum payments and updating agency policies and procedures. - Support audits, reviews, and inspection/salvage of electronic equipment. - Respond to… more
- Philadelphia Insurance Companies (Bala Cynwyd, PA)
- …Marketing Statement: Tokio Marine North America Services (TMNAS) provides professional support services to Tokio Marine Group companies in the United States, ... the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an… more
- Commonwealth Care Alliance (Boston, MA)
- …user acceptance testing, and analyze post production reports for issues + Support collaboration between PI/ Claims and other internal stakeholders related to ... claims management, coding rules and guidelines, and evaluating/analyzing claim outcome results for accurate industry standard coding logic and policies… more
- Elevance Health (Norfolk, VA)
- **PBM Compliance Manager ( Claims Audit)** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, ... while providing flexibility to support productivity and work-life balance. This approach combines structured...granted as required by law. The **PBM Compliance Manager ( Claims Audit)** is responsible for coordinating pharmacy compliance activities… more
- The County of Los Angeles (Los Angeles, CA)
- …systems. + Supervises the review of audit findings prepared by the County Auditor and outside agencies and supervises the preparation of reports to support ... auditing or accounting experience** at the level of Senior Accountant- Auditor , Senior Accounting Systems Technician , Senior Accounting...address the in equalities and disparities amongst race. We support the ARDI Strategic Plan and its goals by… more
- Iowa Department of Administrative Services (Des Moines, IA)
- …team. The Department of Administrative Services(DAS) provides high-quality administrative support to state agencies, ensuring efficient and effective management of ... Financial Accuracy and Compliance - Prepare journal entries, review and pre-audit claims to verify compliance with State and Federal laws, Generally Accepted… more
- Rush University Medical Center (Chicago, IL)
- …each case. **Summary:** As a key role in the Revenue Integrity team, the Auditor & Educator is responsible for conducting reviews of EMR documentation of patient ... feedback and focused educational programs on the results of auditing, review claim denials pertaining to coding, and implement corrective action plans. Exemplifies… more