- UNC Health Care (Hendersonville, NC)
- …the health and well-being of the unique communities we serve. Summary: The Recovery Audit Contractor (RAC) Coordinator (RN) is responsible and accountable for ... all Care Management Denial and Recovery Audit Contractor (RAC) requests and follow-ups, including tracking of approvals and denials as well as coordinating and… more
- AutoZone, Inc. (Memphis, TN)
- **Job Description** The Associate Auditor, Audit Recovery , will be required to: + Utilize analytical and forensic email review skills to audit Merchandising ... Vendors. Acquire a knowledge base of Merchandising concepts and programs and recovery industry knowledge to ensure all recoveries for all concepts are captured… more
- Dignity Health (Bakersfield, CA)
- …errors. The Recovery Manager works in close coordination with internal audit , provider dispute resolution, and finance to maximize cost recovery , reduce ... or GED + Minimum 5 years of progressive experience in healthcare claims recovery , payment integrity, or post-payment audit functions, preferably within a… more
- Caris Life Sciences (Irving, TX)
- …Additionally, managing the response efforts of cross-functional teams during high-pressure recovery activities in line with audit and regulatory compliance, ... Caris is where your impact begins.** **Position Summary** As Director, Disaster Recovery & Incident Management, you'll manage the enterprise framework of Incident,… more
- HUB International (Chicago, IL)
- …their DR plans. + Collaborate with Security/Compliance teams to ensure DR and Backup/ Recovery activities meet all compliance and audit requirements. + Develop ... Senior Director of Cloud and Infrastructure, the Manager of Backup and Disaster Recovery will be a hands-on contributor responsible for overseeing and managing the… more
- Nuvance Health (Danbury, CT)
- …denied or downgraded coverage determinations by managed care, commercial payers, and recovery audit contractors. * Maintain and Model the organization's values ... * Demonstrates regular, reliable and predictable attendance * Performs other duties as required *Other Information:* *Education Skills Experience* * Minimum Education/Training Required: Graduate of an accredited medical school. * Completion of specialty… more
- Mohawk Valley Health System (Utica, NY)
- …Provide peer-to-peer payor review in collaboration with attending physicians. + Support Recovery Audit Contractors (RAC's). + Assist with mitigating barriers to ... discharge and care progression. + Perform concurrent review of cases greater than 4 days or the assigned/estimated GMLOS + Partner with the care management team with the management of LOS, complex care needs and patient throughput efforts. Provide transition… more
- HCA Healthcare (Ocala, FL)
- …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 + Identify… more
- Hospice of Michigan (Ann Arbor, MI)
- …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 deficiencies. +… more
- OneMain Financial (Irving, TX)
- …Databricks, DataStage etc..) and BI platforms (Power BI, Looker) + Experience in disaster recovery planning and audit processes + Exposure to cloud security best ... DR drills for PROD/DR; ensure controlled failover and rapid, verifiable recovery **Performance & Optimization** + Instrument and tune query performance; eliminate… more