- Addiction Recovery Care (Lexington, KY)
- … records, and other pertinent data sources to conduct comprehensive audits of client's medical records in an assigned facility per audit policies and procedures ... documentation of services, and the billing and coding of claims . The Compliance Auditor assists the VP of Compliance...to determine standards of care compliance and medical necessity. + Verifies the accuracy of the facility's… more
- University of Michigan (Ann Arbor, MI)
- …demonstrated through experience in patient billing, revenue cycle, or payer audit medical records production. + Demonstrated proficiency using Microsoft ... and produce medical records needed for Hospital and Professional Billing claims when requested by payers, auditors, or governmental agencies. Prepare medical … more
- Highmark Health (Tallahassee, FL)
- …or Medical Review Committee. + Engages in delivery of audit results and overpayment negotiations.Responsible for recovery/ savings of misappropriated funds paid ... for proactive and investigative purposes to comply with internal audit and regulatory requirements. **ESSENTIAL RESPONSIBILITIES** + Performs investigations into… more
- Kaleida Health (Buffalo, NY)
- …(DRG) assignment, proper reimbursement and quality measure/metrics. Assists with the audit analysis, trending, and presentation of audit /review findings, ... plan and execute quality audits, perform data analysis, trending, presentation of audit /review findings, and identify opportunities and develop a training plan for… more
- Trinity Health (Ann Arbor, MI)
- …insurance, or managed care industries is highly preferred. Experience performing medical claims processing, financial counseling and clearance, or accounting ... for claims processing and maintenance of an accurate electronic medical record. Registers and checks-in patients and determines preliminary patient and insurance… more
- Centene Corporation (Oklahoma City, OK)
- … medical provider office, customer service within a healthcare organization, and medical claims . Knowledge of health care, managed care, Medicare or ... up accurately in the provider information system for state reporting, claims payment, and directories. Responsible for multiple state deliverables, network reporting… more
- The County of Los Angeles (Los Angeles, CA)
- …(CDU), DHS hospitals are training sites for physicians completing their Graduate Medical Education in nearly every medical specialty and subspecialty. In ... addition to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the County's 911 emergency response system, as well as… more
- BD (Becton, Dickinson and Company) (Covington, GA)
- …focus on the quality engineering processes specific to the distribution of medical devices and pharmaceuticals. **Job Description** We are **the makers of possible** ... BD is one of the largest global medical technology companies in the world. Advancing the world...ensure product integrity is safeguarded throughout the shipping process. Audit and Compliance Readiness + Prepare for, coordinate, and… more
- Maxim Healthcare Services (Columbia, MD)
- …with multiple departments on repayment matters as necessary + Obtains billing and medical record information used to support Maxim's claims for reimbursement + ... late timecards, patient loggings, reconciliations, etc. + Summarizes ad hoc audit findings and preliminary recommendations for management review + Prepares reports… more
- LA Care Health Plan (Los Angeles, CA)
- …reporting and corrective action plans monitoring of financial solvency and claims processing compliance for specialty health plans and vendors. These audits ... of business. The position is responsible for the DMHC claims data submissions for LA Care and its Plan...for Centers for Medicare and Medicaid Services (CMS) claim audit section of LA Care delegates. + Annually reviews… more