- LA Care Health Plan (Los Angeles, CA)
- …Annually. Monitoring CMS Audits of LA Care deficient delegates. Participates in Centers for Medicare and Medicaid Services (CMS) claim audit section of LA Care ... Senior Health Care Audit Analyst Job Category: Accounting/Finance Department: Financial Compliance...Plans Auditor III is responsible for planning audits and audit work programs that address appropriate claims and financial… more
- HCA Healthcare (Nashville, TN)
- …criteria is met in compliance with departmental policies and procedures + Review Medicare Recovery Audit Contractor (RAC) recoupment requests and process or ... appeal as appropriate + Compose technical denial arguments for reconsideration, including both written and telephonically + Overcome objections that prevent payment of the claim and gain commitment for payment through concise and effective appeal argument +… more
- Kennedy Krieger Institute (Baltimore, MD)
- …internal and external reporting including the annual financial statement and grant audit , Medicare cost report, and 990 tax filing. **Qualifications** ... leases and contract agreements, corporate legal documents, tax returns, audit reports and financial statements. 3. Coordinate schedules and supervisors'… more
- Baptist Memorial (Memphis, TN)
- …PREFERRED 5 years of healthcare care experience and 3 years in Medicare billing environment. Previous audit experience, knowledge of InterQual and ... TPE Job Code: 21540 FLSA Status Job Family: FINANCE Job Summary Medicare / Medicaid Appeals Registered Nurse reviews and evaluates medical documentation to… more
- CommuniCare Health Services Corporate (Indianapolis, IN)
- Medicare Biller The CommuniCare Family of Companies currently owns/manages over 130 World-Class Nursing and Rehabilitation Centers, Specialty Care Centers, and ... living communities. CommuniCare Health Services is currently recruiting a Medicare Biller for our Central Billing Office in Cincinnati,...+ Verify receipt of monthly triple check forms and audit for accuracy per triple check policy prior to… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- The Medicare Billing and Follow-up Representative are responsible for the compliant, accurate and timely billing and follow-up of all hospital Medicare and ... limited as other tasks may be assigned. + Submit Medicare / Medicare Advantage plan claims both electronic and...of complex scenarios such as interim , self - audit , combined , and split billing etc. +… more
- Centene Corporation (Jefferson City, MO)
- …anywhere in the Continental United States **Position Purpose:** Supports the Medicare Sales Compliance team in the management of regulatory requirements associated ... with the Medicare sales compliance and third-party marketing materials. Consults on...comply with CMS regulatory and contractual requirements. + Analyzes audit data for trends, outliers, and spikes. Transforms data… more
- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and ... educational materials for providers and medical groups. + Participate in additional audit activities for CMS RADV as needed, including retrospective chart reviews. +… more
- Cardinal Health (Hingham, MA)
- …preferred + High School Diploma, GED or equivalent work experience, preferred + Medicare claims and/or audit experience desired + Familiarity with a variety ... of auditing & appeals processes and procedures + Familiarity with healthcare compliance issues, including HIPAA privacy rules & requirements **Anticipated hourly range:** $15 per hour - $18.10 per hour **Bonus eligible:** No **Benefits:** Cardinal Health… more
- e CancerCare (Fresno, CA)
- …Monitor and track financial assistance applications and approvals within Assist Point Audit Medicare Only patients to ensure all assistance available is ... accessed and training completed accordingly Monitor Aging Balance report monthly. Review and complete monthly adjustments including hardship, self-pay, etc. Review all Early Out collection Visit Owners Bi-weekly to ensure claims are properly worked. Ability to… more