- Methodist Health System (Dallas, TX)
- …5 days **Work Shift :** **Job Description :** Your Job: The SR REIMBURSEMENT( MEDICARE ) ANALYST will assist the Manager of Regulatory Compliance, the Manager of ... * Position requires extensive knowledge of governmental programs ( Medicare and Medicaid). * Good written and oral communication...to resolve all issues that come up in the audit of the cost report. Keeps Manager adequately informed… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …with our business partners, the State Medicaid Office and/or the Centers for Medicare and Medicaid Services (CMS). The Compliance Manager will work closely with ... Audits, monitors activities and provides training and clarification of Medicare requirements and other general processes (includes delegates). + Reviews… more
- Covenant Health Inc. (Knoxville, TN)
- …Summary: Performs complex level professional internal auditing work. Work involves compliance audit projects for Covenant Health entities as they relate to charging, ... to documentation and reimbursement. Also provides corporate oversight of any current departmental audit programs. + Reviews data to identify audit issues and… more
- St. James Hospital (Hornell, NY)
- …+ Collaborates with the Controller to assure the completion of the private, Medicare , and all other financial-related audit activities. + Coordinates the ... operations of the Audit Committees of the Hospital Board of Directors and St. James Hospital Foundation. + In collaboration with URMC Payer Contracting and Reimbursement department, negotiates payment/contract agreements with third-party payers and assures… more
- Fairview Health Services (St. Paul, MN)
- …Payment Systems (PPS) for inpatient and outpatient hospital services and the Medicare Physician Fee Schedule (MPFS) applicable to professional services. Must be ... including medical coding, billing, and documentation. + Applies comprehensive knowledge of Medicare and Medicaid guidelines under the Medicare Physician Fee… more
- Fresenius Medical Center (Tupelo, MS)
- …options: + Educates on the availability of alternative insurance options (ie, Medicare , Medicaid, Medicare Supplement, State Renal programs and COBRA). + ... + Discusses insurance options when insurance contracts are terminated. Responsibilities involving Medicare and Medicaid include but are not limited to: + Determining… more
- Covenant Health Inc. (Knoxville, TN)
- …as a Best Employer. Position Summary: Responsible for supervision of clinical audit and appeals processes conducted by Revenue Integrity Department Auditors and ... Appeal Coordinators. Oversees audit and denials management workflow including quality and reporting....coding, modifiers, and billing processes to ensure compliance with Medicare , Medicaid guidelines and other insurance payers and department… more
- Sharp HealthCare (San Diego, CA)
- …Corporate Compliance in accordance to the CMS and local MAC ( Medicare Administrative Contractor) requirements. **Required Qualifications** + 3 Years experience ... and CMS compliance. - Required **Essential Functions** + AuditingParticipates in audit risk assessment for each division/provider to determine trends and helps… 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
- UPMC (Pittsburgh, PA)
- …of topics affecting the financial performance of the health plan; assist with reconciling Medicare Advantage Part C and Part D claims data to financials; analyze bid ... changes; develop assumptions, project costs and monitor emerging experience of Medicare Advantage Mandatory Supplemental Benefits including, but not limited to,… more