- St. Luke's University Health Network (Allentown, PA)
- …The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure codes to assure ... coding determination made by the government or commercial payors, or their auditor representative. + Facilitate clinical chart reviews to assist with supporting… more
- The City of Rochester, MN (Rochester, MN)
- …preferably JD Edwards. Certifications Certified Public Accountant (CPA), Certified Internal Auditor (CIA), or Certified Management Accountant (CMA). If this work ... Fraud Examiner (CFE) + Certified Financial Planner (CFP) + Certified Internal Auditor (CIA) + Enrolled Agent (EA) + Certified Government Financial Manager (CGFM)… 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 ... organizational skills. **Preferred Job Qualifications:** * Certified Professional Medical Auditor (CPMA) and/or Surgical Coding certifications * Experience working… more
- AmeriHealth Caritas (Newtown Square, PA)
- …; The manager must have the ability to determine correct coding, review claims , medical records and billing data from all types of healthcare providers for ... performance goals. + Proactively identify and analyze patters or anomalies in pharmacy claims and operations indicative of fraud, waste and abuse.; + Lead and manage… more
- UGI Corporation (King Of Prussia, PA)
- …records and assist with drafting corporate resolutions and secretary's certificates. Handle auditor request letters. + Real Estate: Assist on right of way reviews, ... access agreements. + Litigation: Assist on discovery responses, filings for small claims , managing internal litigation docket and review filings as necessary, state… more
- The Cigna Group (Bloomfield, CT)
- …needed and provide background knowledge needed to interpret audit scope. As a Staff Auditor , this position may act as a resource for less experienced team members ... to base an informed, objective assessment of the accuracy and legitimacy of claims audited. + Utilize personal knowledge of medications and available tools including… more
- The County of Los Angeles (Los Angeles, CA)
- …requirements for Federal, State, and/or Special Programs to determine if claims for reimbursement conform to applicable rules and regulations and result ... Health Services or Mental Health, departmental administration and by the Auditor -Controller when necessary. Writes policy and procedure manuals pertinent to… more
- The County of Los Angeles (Los Angeles, CA)
- …and our communities by providing extraordinary care. DEFINITION: Prepares reimbursement claims for health and/or mental health care provided under Federal, State ... requirements for Federal, State, and/or Special Programs to determine if claims for reimbursement conform to applicable rules and regulations and result… more
- The County of Los Angeles (Los Angeles, CA)
- …permanent appointment to Health Care Financial Analyst. DEFINITION: Prepares reimbursement claims for health and/or mental health care provided under Federal, State ... requirements for Federal, State, and/or Special Programs to determine if claims for reimbursement conform to applicable rules and regulations and result… more
- The County of Los Angeles (Los Angeles, CA)
- …payments, preparing invoices for services rendered, processing employee expense claims for reimbursements, cash receipts and reimbursing revolving funds. Apportions ... assets. Reviews trial balances of accounts and reconciles to the Auditor -Controller's Countywide Accounting and Purchasing System (eCAPS) and subsidiary ledgers and… more