- Trinity Health (Des Moines, IA)
- …discrepancies with Medical Records Department and Admitting Department. + Collaborates with the Recovery Audit Contractor ( RAC ) Coordinator and Conifer ... for Medicare/Medicaid RAC Denials management. **MINIMUM KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:** + Current licensure as a registered nurse in the State of Iowa. + Five (5) years clinical nursing experience. + Bachelor of Science - Nursing or degree in… more
- Penn Medicine (Bala Cynwyd, PA)
- …of documents related, but not limited to, Office of the Inspector General (OIG), Recovery Audit Contractors ( RAC ), Medicaid Integrity Contractors (MIC), Zone ... responsible for the daily management and tracking of Government audit activity received by Penn hospitals, provider groups and...to receipt and reconciliation of denial notices from the contractor and N432 RAC remarks. Reviews 835/837… more
- State of Colorado (Denver, CO)
- …Provider Payment Reviews + Fraud Investigation + Waste and abuse reviews and recoveries + Recovery Audit Contract ( RAC ) + Data analytics and data mining for ... Investigation + Waste and abuse reviews and recoveries + Recovery Audit Contract ( RAC ) +...describe your experience working with FWA vendors, for example, RAC vendors. What kind of contractor oversight… more
- Vestis Services (Roswell, GA)
- …+ Oversee complex installation, configuration, upgrades, and patching, including Oracle RAC clusters and Microsoft SQL Server HA clusters. + Develop and ... implement advanced high-availability (HA) and disaster recovery (DR) strategies aligned with business needs. + Design...Security and Compliance:** + Partner with internal and external audit teams to ensure compliance with SOX (Sarbanes-Oxley Act)… more
- Watco Companies LLC (Pittsburg, KS)
- …advancement opportunities Starting Hourly Rate: $21.00 A Revenue Accounting Clerk ( RAC ) is responsible for assisting in capturing revenue timely and accurately ... able to understand how the revenue is applied. The RAC will be able to answer basic revenue related...regarding the location(s) in which they are required to audit . Job Duties + Read and understand tariff and… more
- LifePoint Health (Rutherfordton, NC)
- …discharge plans.5. Follows up with any denials through the appeals process; including RAC chart audit reviews. Emergency Department (ED) Case Management1. Serves ... and assure documentation meets Medicare requirements to reduce the risk related to RAC 's.5. Documentation in the medical records is completed in the appropriate time… more
- Highmark Health (Helena, MT)
- …entities in response to external coding audits conducted by the Medicare Administrative Contractor , the RAC , MIC, ZPIC, etc. Determine appeal action, prepare ... OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and… more
- UL, LLC (Allentown, PA)
- …+ Assess and report in accordance with UL, industry scheme, and client audit protocols on facilities working and/or operational conditions as it relates to ... 21CFR111 + Medical/Homecare Devices: 21CFR820 + Cosmetics: ISO22716 #MB-1 #LI-Remote Complete audit agendas within 14 calendar days of the audit Complete… more
- Sharp HealthCare (San Diego, CA)
- …is responsible for the administration of the Sharp HealthCare's (SHC's) compliance audit program. The position provides oversight and maintenance of a high-quality, ... effective, best practices coding, billing, and reimbursement audit compliance program to prevent and detect violations of...risk analyzer software, OIG Work plan, CMS, PEPPER Reports, RAC Denials, industry experts, etc. + Policy and Procedure… more
- St. Luke's University Health Network (Allentown, PA)
- …and procedure code assignment and MS-DRG/APR-DRG accuracy based on denials or audit findings from government and commercial payers. Meet or exceed established ... the physician advisor in review of patient medical records identified by RAC /MIC/QIO and other governmental or commercial payor auditors in retrospective reviews for… more