- WMCHealth (Valhalla, NY)
- …up and maintained. + Software & Data Management + Maintain, test, and audit split-billing software and associated data feeds, ensuring accuracy and compliance. + ... Develop and refine claims qualification logic and data feeds for contract pharmacy...& Compliance Oversight + Develop and maintain a 340B audit compliance program, executing self-audits and implementing corrective action… more
- Sharp HealthCare (San Diego, CA)
- …as appropriate for approval at the UM Care Coordinator level of review.Appropriately identify claims for review by the Medical Director to include obtaining the ... of the requested service. This position is responsible for conducting retrospective claims review for services to determine the medical appropriateness of the… more
- Community Health Systems (Birmingham, AL)
- …reports issues, problems, and important information to management. + Works all vendor/payer audit trails and files secondary claims . + Performs other duties as ... payers. This position performs all needed research to ensure claims are filed timely, accurate and efficient in accordance...part of the application or hiring process, contact the director of Human Resources at the facility to which… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- …False Claims Act and anti-kickback statutes. + Support Associate Director , Healthcare Law Auditing & Monitoring with other assignments as needed. ... healthcare laws, regulations and guidance (such as the Anti-Kickback Statute, False Claims Act, OIG Guidance for Pharmaceutical Manufacturers, PhRMA Code, FDCA and… more
- BAYADA Home Health Care (Pennsauken, NJ)
- …accurate production of bills along with the collection of outstanding invoices and claims . Responsible for the direct supervision of staff within the assigned unit. ... : + Manage and ensure timely production and submittal of invoices/ claims and accounts receivable management through effective supervision of Reimbursement Services… more
- Wolters Kluwer (Minneapolis, MN)
- …Analysts, Quality Assurance Analysts, Operations Support Specialists, Managers, Associate Directors, and Director . You will supervise and lead a group of 8+ legal ... heavy periods of incoming invoice volume, conduct the initial audit and/or quality assurance invoice review audit ...prior supervisory experience, preferably in a legal billing or claims environment. + 5+ years' experience in the legal… more
- Walmart (Red Bluff, CA)
- …environmental impacts and assessments + Supports regulatory visits and prepares audit reports for management review + Assists in integrating environmental ... Assists with third party audits + Develops and presents audit findings to facility management + Responds to inquiries...to inquiries by regulatory authorities + Consults on complex claims and settlements + Designs preventative claims … more
- Nobis Works (Atlanta, GA)
- …and procedures for the organization and provide technical assistance to the Director , People & Culture, including but not limited to: assisting employees with ... hire orientations and arranging/monitoring training programs, processing worker's compensation claims , implementing new HR initiatives, recruiting, maintaining documentation and… more
- Stoneleigh-Burnham School (Greenfield, MA)
- …. Preparing and processing bi-weekly 403B contributions. . Completing the annual 403B audit . . File workers' compensation claims as they occur and follow ... accounts to the general ledger in preparation for the audit , preparing any necessary journal entries that are needed,...with the bookstore. . Reconcile camp accounts with the Director of Auxiliary Programs. . Assist the CFO with… more
- University of Utah (Salt Lake City, UT)
- …interprets state and federal regulations regarding payments in health care to audit claims correctly. **Minimum Qualifications** Bachelor's degree in Health Care ... documentation. The position will utilize coding knowledge to abstract, record and audit data from medical records. Provides support to areas related to… more
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