• Clinical Government Audit Analyst & Appeal…

    Stanford Health Care (Palo Alto, CA)
    …180 Days or + CCDS - Cert Clinical Document Spec required within 180 Days + RN - Registered Nurse - State Licensure And/Or Compact State Licensure required ... **A Brief Overview** Clinical Government Audit Analyst and Appeal Specialist II plays a critical role in...Health Care's organization competencies and Code of Conduct. + Denial Analysis: Conduct thorough analyses of denials, evaluating the… more
    Stanford Health Care (10/10/25)
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  • MassHealth & Medicare Regulatory Compliance…

    Commonwealth Care Alliance (Boston, MA)
    …Claims Operations & Quality Assurance, the Regulatory Compliance & Audits Sr. Specialist II is responsible for ensuring CCA's operational compliance with ... to compliance inquiries from internal teams regarding benefit design, denial logic, or claims workflows. * Assist in the...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an… more
    Commonwealth Care Alliance (09/01/25)
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