• Medicare ISNP Enrollment Agent - SC

    PruittHealth (Greenville, GA)
    …and enrollments. 6. Ability to learn and carry out Centers for Medicare & Medicaid Services rules and regulations. 7. Meet with potential members/responsible ... with the member are compliant with CMS regulations 11. Conduct monthly facility audit in accordance with monthly checklist provided. 12. The Enrollment Agent will be… more
    PruittHealth (05/30/25)
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  • HIM Audit and Education Specialist

    Hartford HealthCare (Farmington, CT)
    …programs and other common practices across the system. *_Position Summary:_* The Audit & Education Specialist develops and implements an effective and comprehensive ... audit & education program for coding consistent with regulatory,...4. Researches literature from regulatory groups such as; HHS/OIG, Medicare , Medicaid, NGS, etc., professional and peer organizations' practices/policies/guidelines… more
    Hartford HealthCare (04/24/25)
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  • Manager, FP&A Medicare Part D

    CVS Health (Woonsocket, RI)
    …critical role will serve as a key financial lead supporting the Medicare Part D and SilverScript Organization. Primary responsibilities for this position include ... coordination and execution of Medicare Part D Bid requirements including; several round of...Bid requirements including; several round of non-benefit expense (NBE), audit requests, Worksheet 1 and other ad hoc bid… more
    CVS Health (05/30/25)
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  • Sr Project/Program Manager ( Medicare

    BlueCross BlueShield of North Carolina (NC)
    **Job Description** This role oversees the Medicare Prescription Payment Plan (M3P), working closely with internal matrix partners and external vendors to ensure all ... administered timely, accurately and in compliance with the Centers for Medicare and Medicaid Services (CMS) requirements. Ensures that future program enhancements… more
    BlueCross BlueShield of North Carolina (05/28/25)
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  • Audit & Reimbursement II (US)

    Elevance Health (Manchester, NH)
    Medicare and Medicaid Services to transform federal health programs. The ** Audit and Reimbursement II** will support our Medicare Administrative Contract ... ** Audit & Reimbursement II** **Location:** This role enables...(MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department… more
    Elevance Health (05/30/25)
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  • Customer Solution Center Audit Readiness…

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... to achieve that purpose. Job Summary The Customer Solution Center (CSC) Audit Readiness Specialist II is responsible for the execution, oversight, and monitoring… more
    LA Care Health Plan (05/29/25)
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  • Manager, Internal Audit (Remote-Hybrid)

    RWJBarnabas Health (Oceanport, NJ)
    Manager, Internal Audit (Remote-Hybrid)Req #:0000196245 Category:Accounting/Finance Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services ... Department:Internal Audit Location: System Business Office, 2 Crescent Place, Oceanport,...+ Strong knowledge of healthcare regulatory requirements (eg, HIPAA, Medicare /Medicaid). + Exceptional analytical and problem-solving skills, with the… more
    RWJBarnabas Health (04/10/25)
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  • Coding Audit Response Specialist

    Novant Health (NC)
    Job Summary + The Coding Audit Response Specialist position responds to external and internal audits that include an assessment of ICD-10- CM/PCS, CPT or HCPCS codes ... the accuracy of assignment for Novant Health Facilities as assigned by Corporate Coding Audit Response Lead. + Audits will include but will not be limited to: coding… more
    Novant Health (05/31/25)
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  • Coding Audit Response Specialist

    Novant Health (NC)
    Job Summary The Coding Audit Response Specialist position responds to external and internal audits that include an assessment of ICD-10- CM/PCS, CPT or HCPCS codes ... the accuracy of assignment for Novant Health Facilities as assigned by Corporate Coding Audit Response Lead. Audits will include but will not be limited to: coding… more
    Novant Health (05/30/25)
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  • Manager ROI Audit Research

    Beth Israel Lahey Health (Burlington, MA)
    …making a difference in people's lives.** Manages all functions of the ROI/ Audit and Research Department. Utilize technology to support ongoing efforts to protect ... Duties & Responsibilities:** **Supervisory Functions** **Manage all functions of the ROI/ Audit & Research Department: Front desk services, release of information,… more
    Beth Israel Lahey Health (05/16/25)
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