- Guthrie (Sayre, PA)
- Summary The Denial, Appeal, and Audit Manager is responsible for the oversight and management of all payer denials, appeals, and audit processes within the ... resolution of claim denials, effective appeal strategies, and proactive audit response. The manager leads a team of specialists,... Oversight + Manage payer and third-party audits (eg, RAC , MAC, UPIC, commercial payers) + Coordinate timely record… more
- Beth Israel Lahey Health (Newburyport, MA)
- …direction of the Director of Health Information Management, the Health Information Management Audit Specialist handles various audit requests for the release of ... all the logging and tracking of requests and the audit process from initiation through mailing, in collaboration with...request for specificity in the documentation requested (eg, MAC, RAC , Payor Audits, Compliance Audits) and verifies that the… more
- HCA Healthcare (Plano, TX)
- …criteria is met in compliance with departmental policies and procedures + Review Medicare Recovery Audit Contractor ( RAC ) recoupment requests and process ... or appeal as appropriate + Compose technical denial arguments for reconsideration, including both written and telephonically + Overcome objections that prevent payment of the claim and gain commitment for payment through concise and effective appeal argument +… more
- Hospice of Michigan (Ann Arbor, MI)
- …complete responses to Additional Development Requests (ADRs), Comprehensive Error Rate Testing (CERT), Recovery Audit Contractor ( RAC ) etc., requests and ... participates in appeal processes. + Participates in the development and annual revision of Quality Assessment and Improvement Plans and Program Evaluation. + Participates in analyzing, developing, coordinating and implementing plans of correction for noted… more
- Celestica (Maple Grove, MN)
- …and partners, and ensuring compliance with regulatory requirements (FDA, ISO, ASQ, RAC ). The position is virtual, offering competitive compensation and career growth ... customer surveys, operational reviews, and system applications. * Cultivate an " audit -ready" culture and direct the Global Regulatory Compliance Audit … more
- System One (Washington, DC)
- …* Manage user accounts, roles, and permissions to maintain data security. * Audit database activities and log changes. * Maintain detailed documentation of database ... including VMWare, Azure (IaaS/PaaS), and on-premises. * Experience with Oracle RAC , Oracle Enterprise Manager, RMAN backups, Oracle Data Guard, and setting… more
- TAD PGS, Inc. (Washington, DC)
- …+ Manage user accounts, roles, and permissions to maintain data security. + Audit database activities and log changes. + Maintain detailed documentation of database ... including VMWare, Azure (IaaS/PaaS), and on-premises. + Experience with Oracle RAC , Oracle Enterprise Manager, RMAN backups, Oracle Data Guard, and setting… more
- ABBTECH Professional Resources, Inc. (Washington, DC)
- …* Manage user accounts, roles, and permissions to maintain data security. * Audit database activities and log changes. * Maintain detailed documentation of database ... including VMWare, Azure (IaaS/PaaS), and on-premises. * Experience with Oracle RAC , Oracle Enterprise Manager, RMAN backups, Oracle Data Guard, and setting… more
- Community Health Systems (Franklin, TN)
- …The DRG Denials Auditor conducts hospital inpatient DRG denial audits for both RAC and non- RAC accounts, reviewing patient records for accuracy in ICD-10-CM/PCS ... to payers with a strong attention to detail. Additionally, the auditor provides audit feedback to relevant parties, including coders and coding managers, to improve… more
- Houston Methodist (Katy, TX)
- …ethical and legal business practices and accreditation/regulatory/ government regulations. + ** Audit Oversight & Lifecycle Management** + Lead the management and ... response process for a variety of audits including RAC , MAC, CERT, PERM, TPE, and commercial payer audits....quality review, and timely submission. + Track and analyze audit trends, denials, and appeal outcomes to identify risks… more