- Genesis Healthcare (Kankakee, IL)
- Overview Sub-Acute, Long-Term Care is a sector of healthcare exploding with potential and work-life balance flexibility, with no on call! We are seeking a ... Fee-For-Service Attending Physician/Medical Director for our Riverside Miller Healthcare Center, located in Kankakee, IL. This is a Dual Role Attending… more
- BJC HealthCare (St. Louis, MO)
- …qualifications and relevant work experience) **Additional Information About the Role** BJC HealthCare is seeking a Lead, Patient Accounting for our hospital AR ... follow up team! **Overview** **BJC HealthCare ** is one of the largest nonprofit health care...internal and external questions regarding revenue, cash reconciliation and claims corrections. + Utilizes thorough understanding of the revenue… more
- Genesis Healthcare (Camp Hill, PA)
- …within the Compliance and Ethics Program, Standard/Code of Conduct, Federal False Claims Act and HIPAA. 2. Participates in required orientation and training ... Officer via the Integrity Hotline. 4. Cooperates with monitoring and audit functions and investigations. 5. Participates, as requested, in quality assurance… more
- Genesis Healthcare (Roosevelt, NY)
- …within the Compliance and Ethics Program, Standard/Code of Conduct, Federal False Claims Act and HIPAA. 2. Participates in required orientation and training ... Officer via the Integrity Hotline. 4. Cooperates with monitoring and audit functions and investigations. 5. Participates, as requested, in quality assurance… more
- Elevance Health (Richmond, VA)
- …is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and ... submitted DRG. **How you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines and objectivity in… more
- Highmark Health (Pittsburgh, PA)
- …This job is responsible for development and implementation of strategic audit plans utilizing numerous inputs including contracts, industry trends and revenue ... maximization schemes. The incumbent will also work with other audit team members and external vendors to develop specific auditing techniques to identify overbilling… more
- HUB International (Chicago, IL)
- …a plus. Experience: A minimum of 3-5 years of experience in the PBM industry, healthcare claims auditing, or a related field. Direct experience with PBM audits ... of Pharmacy Benefit Managers (PBMs) to ensure contractual compliance, accurate claims processing, and proper financial management. This role involves in-depth data… more
- Elevance Health (Mason, OH)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... coding principles, clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding expertise, mastery of… more
- Trinity Health (Ann Arbor, MI)
- …for the purpose of establishing the patient and service specific record for claims processing and maintenance of an accurate electronic medical record. Registers and ... information system(s), to ensure accurate and timely submission of claims . Determines visit-specific co-payments and collects out-of-pocket liabilities. Assists… more
- Elara Caring (Broken Arrow, OK)
- … Management team. + Performs claims audits for Medicare and non-Medicare claims through completion of claim audit Workflow. + Reviews and clears held ... our mission every day. Join our elite team of healthcare professionals, providing the Right Care, at the Right...business teams including finance, business configuration, quality assurance, payer audit , and others to clear held claims .… more