- Robert Half Office Team (Los Angeles, CA)
- …required for travel to onsite audits. + 1-3 years of experience in credentialing or Medicare audit functions. + At least 2 years of direct experience conducting ... to ensure continued compliance with contractual and regulatory requirements. + Audit internal credentialing processes to ensure compliance with CMS (Centers for… more
- Elevance Health (St. Louis, MO)
- … Medicare and Medicaid Services to transform federal health programs. The ** Audit and Reimbursement Senior** will support our Medicare Administrative Contract ... + Requires a BA/BS and a minimum of 8 years of audit /reimbursement or related Medicare experience; or any combination of education and experience which would… more
- Robert Half Office Team (Monterey Park, CA)
- … audit work. + One (1) to three (3) years of experience in credentialing or Medicare audit roles required. + A minimum of two (2) years of experience in ... Develop, implement, and manage corrective action plans to address audit findings. + Monitor, analyze, and report data to...audit processes is necessary. + Advanced knowledge of Medicare Advantage CMS and California DMHC regulations. + In-depth… more
- Elevance Health (Hingham, MA)
- …Requirements:** + Requires a BA/BS degree and a minimum of 5 years of audit /reimbursement or related Medicare experience; or any combination of education and ... ** Audit & Reimbursement III** **Location** : This role...Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare… more
- Walmart (Orlando, FL)
- …process Medicare orders to ensure compliance; and interpreting and documenting Medicare audit documents. + Ensures fulfillment of pharmacy prescriptions in a ... documentation; and maintaining a safe and clean work environment. + Complies with Medicare and Medicaid policies and procedures by implementing and adhering to rules… more
- Charter Care Health Partners (Providence, RI)
- …year; submit executive summary and action plan to the GME Office + Prepare Medicare Audit documents, per the GME Office's instructions + Manage fellow financial ... program's New Fellow Orientation (print documents, etc.) + Research forms for Medicare reimbursements for fellowships with dedicated research time, if applicable +… more
- WelbeHealth (Boston, MA)
- …growth drivers + Assist with month-end close, quarterly financial reporting, financial audit , Medicare /Medicaid audits, and other PACE specific projects + Keep ... payment model, including ability to track and analyze revenue streams (eg Medicare , Medicaid, Part D) along with PACE rates and regulatory constructs **Job… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …exposure to all areas of BCBSMA, with a focus on senior product strategy and Medicare Markets. This candidate must be a creative thinker with the ability to drive ... collaboratively with both technical and non-technical staff including Underwriting, Medicare Product Development, Provider Contracting, Sales, and others across the… more
- Robert Half Finance & Accounting (Eatontown, NJ)
- …State and federal issued reimbursement rates + Investigates and responds to audit reviews/questions/adjustments + Monitor Medicare and Medicaid appeal and cost ... Eatontown and offers a hybrid schedule, has an opportunity for a Director Medicare /Medicaid Reimbursement. + The Director will have advanced level of knowledge of… more
- Humana (Concord, NH)
- …other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and will understand how ... participate in meetings involving care management, provider relations, quality of care, audit , grievance and appeal and policy review. The Behavioral Health Medical… more