- SSM Health (MO)
- …Performs as a vital member of the interdisciplinary care team member, an auditor , and an educator ensuring medical records are complete and clinical documentation ... risk adjustment (mortality) findings. + Maintains knowledge of Centers for Medicare and Medicaid Services (CMS) requirements related to clinical documentation and… more
- CVS Health (Hartford, CT)
- …and GAAP PDR calculations. + Complete annual gross premium valuations for Medicare Supplement business. + Manage the relationship with the external vendor for ... ratio reporting. + Provides required materials and responds to internal and external auditor questions. + Builds tools and models that help to understand and address… more
- The County of Los Angeles (Los Angeles, CA)
- …rules and regulations and result in maximum revenue collection. Prepares Medicare and Medi-Cal cost reports and State mandated disclosure reports. Analyzes ... Health Services or Mental Health, departmental administration and by the Auditor -Controller when necessary. Writes policy and procedure manuals pertinent to… more
- LA Care Health Plan (Los Angeles, CA)
- …Health Care (DMHC), Department of Health Care Services (DHCS), Centers for Medicare and Medicaid Services (CMS), and other federal and state guidelines. Responsible ... following Licenses/ Certifications: Certified Public Accountant (CPA) Certified Internal Auditor (CIA) Certified Management Accountant (CMA) Certified Fraud Examiner… more
- Kestra Medical Technologies, Inc (Kirkland, WA)
- …controls. + Assist with the coordination and gathering of documents to support auditor requests as needed + Participate in other duties and assignments as needed ... products regulated by the Federal Food and Drug Administration and under contract with Medicare . Kestra maintains a drug free workplace and testing is a condition of… more
- AdventHealth (Altamonte Springs, FL)
- …practitioners, nursing, care management and quality abstracters. The Quality Auditor Manager adheres to strict departmental and organizational goals, objectives, ... nursing, and care management. This includes quarterly compliance updates from Medicare . + Effectively and appropriately communicates with physicians and other… more
- Highmark Health (Austin, TX)
- …of the Following)** + Certified Public Accountant (CPA) + Certified Internal Auditor (CIA) + Certified Fraud Examiner (CFE) + Certified in Healthcare Compliance ... and cross-functional strategy development. + Experience with managed care, Medicare and federal and/or state regulations, quality improvement and compliance… more
- The County of Los Angeles (Los Angeles, CA)
- …rules and regulations and result in maximum revenue collection. + Prepares Medicare and Medi-Cal cost reports and State mandated disclosure reports. + Analyzes ... by Health Services or Mental Health, departmental administration and by the Auditor -Controller when necessary. + Writes policy and procedure manuals pertinent to… more
- Houston Methodist (Houston, TX)
- …accreditation or health care certifications **OR** + CQA - Certified Quality Auditor (ASQ) -- Related quality, accreditation or health care certifications **OR** + ... care regulatory and accreditation requirements (such as Centers for Medicare /Medicaid Services/CMS, CMS approved hospital accreditation organizations and State… more