- Providence (Renton, WA)
- …not simply valued - they're invaluable. Join our team at Integrity Compliance Audit Services and thrive in our culture of patient-focused, whole-person care built on ... training, job aides and technical support for caregivers regarding Centers for Medicare and Medicaid Services (CMS) Medicare Secondary Payer reporting,… more
- Hartford HealthCare (Farmington, CT)
- …Must have a working knowledge of the healthcare industry that includes Medicare Cost Reporting and State OHS reporting, reopenings/appeals, healthcare surveys and ... and assists in the preparation supporting workpapers and filing of annual Medicare Cost Reports ensuring strict compliance with all Medicare regulations,… more
- New York State Civil Service (NY)
- …research on the organization to be audited; * assists in establishing the scope of audit by analyzing and determining areas for audit , and timeframe to be ... examined; * assists in planning audit activities, including specific audit tasks, and...maintain eligibility for full and unconditional participation in the Medicare and Medicaid programs. Continued employment will depend on… more
- HCA Healthcare (Nashville, TN)
- …the opportunity to make a difference. We are looking for a dedicated Inpatient Coding Audit Manager like you to be a part of our team. Job Summary and Qualifications ... cost-effective healthcare in the communities we serve. The Internal Audit Department provides an independent appraisal function to validate...as a RHIA or RHIT, with CCS preferred + Medicare Inpatient and Outpatient Coding Experience + Ability to… more
- The Cigna Group (St. Louis, MO)
- …, Compliance, Legal and other stakeholders to respond to State, Center for Medicare and Medicaid Services (CMS) and Client audit requests. **Key accountabilities ... **Overview** The Advisor Regulated Markets Audit Management role is responsible for coordinating the...planning, execution and follow up for client and regulatory audit activities within Regulated Markets. This individual serves as… more
- LA Care Health Plan (Los Angeles, CA)
- …Claims is responsible for various tasks within the Financial Compliance Unit, including audit of claims processed by medical groups and health plans contracted with ... responsible for all aspects of assigned claim audits, including audit testing and completion of the audit ...for a variety of complex areas of the Medi-Cal, Medicare , Covered California, and PASC-SEIU benefit and process. This… more
- Hartford HealthCare (Hartford, CT)
- …Program Manager of Revenue Compliance will have a firm understanding of the Medicare IPPS, OPPS and ASC payment system. Works to develop strong relationships with ... revenue compliance initiatives, projects and audits per the OCI Work and Audit Plan, developing strong working relationships with system management, employees and… more
- HCA Healthcare (Nashville, TN)
- …make a difference. We are looking for a dedicated Regulatory and Accreditation Clinical Compliance Audit Manager? like you to be a part of our team. Job Summary and ... Qualifications The Internal Audit Department provides an independent appraisal function to validate...understanding of The Joint Commission (TJC), The Centers for Medicare and Medicaid Services (CMS), federal and state regulations.… more
- Molina Healthcare (Spokane, WA)
- …with the standards and requirements established by the Centers for Medicare and Medicaid **Knowledge/Skills/Abilities** * Leads, organizes, and directs the ... to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight, monitoring and… more
- Medical Mutual of Ohio (OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Acts as a subject ... matter expert and collaborates with various internal departments to ensure that Medicare Advantage (MA) clinical programs and regulatory reporting are compliant with… more