- 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:** Pharmacy/Clinical Service Data… more
- YAI (Manhattan, NY)
- …Functions & Responsibilities + Reviews and interprets patient eligibility and claims data from various sources (explanation of benefits, remittance statements, ... collections reports, etc.) to assess the correctness of claims submitted for processing, identifying and communicating discrepancies, issues and/or missing… more
- Beth Israel Lahey Health (Burlington, MA)
- …and interpret third-party payments, adjustments, and denials. Initiates corrected claims , appeals, and analyzes unresolved third-party and self-pay accounts, ... to navigate the hospital billing system to identify paid claims or root causes of denial when assessing physician...meetings and serves on committees as requested. Maintains appropriate audit results or achieves exemplary audit results.… more
- State of Georgia (Fulton County, GA)
- …Summary Under the direction of the Fraud Unit Director, assists in healthcare investigations by: reviewing provider and recipient records, by making determinations ... to whether proper diagnostic and procedure codes were used in submitting claims to the Georgia Medicaid Program. Maintains a comprehensive understanding of current… more
- University of Michigan (Ann Arbor, MI)
- …**Why Join Michigan Medicine's Hospital Billing Audits & Appeals (HBAA) Department?** The Audit and Appeals Specialist has a strong knowledge of medical appeal and ... audit practices for both the inpatient and outpatient populations....inspire, and develop outstanding people in medicine, sciences, and healthcare to become one of the world's most distinguished… more
- WellSpan Health (York, PA)
- …qualified patients, drugs and locations. Monitors and audits state Medicaid claims to ensure compliance to prevent potential duplicate discount rebates. Evaluates ... and improve 340B Program compliance and performance and for compliance and audit purposes. Maintains up-to-date policies and procedures on 340B purchasing processes.… more
- Covenant Health Inc. (Knoxville, TN)
- …reports every morning. + Follows up on identified deficiencies related to the billing claims audit within 24 hours following receipt of the Billing Claims ... reports every morning. + Follows up on identified deficiencies related to the billing claims audit within 24 hours following receipt of the Billing Claims… more
- CenterLight Health System (NY)
- …+ Coordinate with healthcare providers, practice managers, and coders to submit claims appropriately and timely. + Audit billing and collection procedures to ... conversion, ESRD, and Nursing Home entitlements. + Perform membership and claims analytics, including IBNR, MMR and 820/834 reconciliation. + Perform reconciliation… more
- Arab Community Center for Economic and Social Serv (Dearborn, MI)
- … for services provided at all clinics. Employee is responsible for submitting claims for reimbursement and coach healthcare providers to achieve optimal ... + Document conversations with insurance companies and patients + Audit agency reports for procedures with office billing to...correct codes into patients- electronic health records + Review claims to make sure coding is accurate + Work… more
- Baylor Scott & White Health (Dallas, TX)
- …individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core ... issues. Develops relationships with internal and external physicians, administrators, healthcare delivery system leaders, and other stakeholders to strengthen and… more