- Houston Methodist (Houston, TX)
- …Compliance and other committees as required. Works collaboratively with the Internal Audit and Business Practices to respond to deficiencies and to strengthen ... Clinical Research Billing Compliance. + Provides oversight and performs detailed claims analysis and medical record review as necessary, including the following:… more
- Trinity Health (Columbus, OH)
- …We're dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a wide variety ... of professional roles including information technology, financial analysis, audit , provider relations and more. **Position Purpose** Contracts/Benefits Configuration… more
- Nestle (New York, NY)
- …necessary related to the Safety Management program. + Ensure sites maintain continuous " audit ready" state of compliance with company SH&E policies and procedures as ... as all applicable external regulatory requirements. + Initiates WC Claims to insurance provider. + Ensure all locations have...rewards package, which includes a 401k with company match, healthcare coverage and a broad range of other benefits.… more
- UIC Government Services and the Bowhead Family of Companies (San Antonio, TX)
- …coordination of services between the military medical facility and the civilian healthcare facility from which medical services are being obtained. + Assist in ... verification of required administrative documentation. Prepare spreadsheets and use them for audit tracking and generation of various outcome reports. + Use MHS… more
- CVS Health (Irving, TX)
- …Linux OS, GCP/ AWS/ Azure. + Experience working with medical and/or pharmacy claims data. + Experience in healthcare industry, including health insurance, PBM ... work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and operational information… more
- Walgreens (Vancouver, WA)
- …usage of medications, awareness with drug interactions and offering preventive healthcare services such as immunizations. Responsible for ensuring the proper ... Supports efforts on enhancing customer experience by increasing focus on healthcare services (eg patient consultation, medication management, drug therapy reviews,… more
- Humana (Oklahoma City, OK)
- …JD, MSN, Clinical Certifications, CPC, CCS, CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. + ... ensuring appropriateness of billing practices + Prepares complex investigative and audit reports + Understands department, segment, and organizational strategy and… more
- Caris Life Sciences (Irving, TX)
- …cancer. We're pushing the frontiers of medicine and leading a revolution in healthcare -driven by innovation, compassion, and purpose. **Join us in our mission to ... + Lead the appeals and reconsideration process for denied Caris claims , including those for CGP (comprehensive genomic profiling) and other proprietary… more
- Brighton Health Plan Solutions, LLC (Westbury, NY)
- …Balance and Subrogation Recoveries ensuring all recoveries received are processed by claims department and then appropriately accounted for and returned to clients. ... + Complete balance sheet reconciliations. + Assist with external audit as needed. + Serve as a back-up for...our people are committed to the improvement of how healthcare is accessed and delivered. When you join our… more
- Trinity Health (Livonia, MI)
- …(nice to have) Possess & maintain licensure or certification in compliance, law, audit , privacy, healthcare , or other relevant field or area of study. ... (RHIT), or Registered Health Information Administrator (RHIA). Certification in Healthcare Compliance ("CHC") designation or willingness to obtain certification… more