- Guthrie (Sayre, PA)
- … Manager is responsible for the oversight and management of all payer denials, appeals , and audit processes within the health system. This role ensures timely ... or insurance with responsibility and management of billing and reimbursement . Essential Functions Denials & Appeals Management...reports to track denial rates, appeal success rates, and audit recoveries + Provide monthly summaries to senior… more
- University of Southern California (Alhambra, CA)
- …determining the need for appeal. Performs all 1st and 2nd level coding-related denial appeals . All tasks & duties to be perform in compliance with federal & state ... or delay payment of a particular claim or group of claims. Prepares appeals and rebuttals letters/packages in responses to payer's reason for coding-related 'claims… more
- Stanford Health Care (Palo Alto, CA)
- …of all legitimate reimbursement opportunities. + Oversee Medicare and Medi-Cal audit processes, addressing inquiries and pursuing appeals or litigation when ... Health Care job.** **A Brief Overview** The Director of Reimbursement is a key leadership role within the Controller's...shaping the financial integrity of the organization. As a senior member of the team, this individual actively contributes… more
- Molina Healthcare (UT)
- **JOB DESCRIPTION** **Job Summary** Provides senior level support for accurate and timely intake and interpretation of regulatory and/or functional requirements ... related to but not limited to coverage, reimbursement , and processing functions to support systems solutions development and maintenance. This role includes… more
- Bristol Myers Squibb (Tampa, FL)
- …ad-hoc inquiries, as well as ensuring the timely completion of audit requests and providing necessary information for compliance, audits, contract management, ... designed; supports the implementation and adherence to SOX controls and compliance, audit activities as needed, ensures compliance for all plan documents and… more
- Catholic Health (Buffalo, NY)
- …budget impacts on Catholic Health (CH), reviewing opportunities and the monitoring of reimbursement . The Manager assists Senior Leadership with the review and ... Exempt: Yes Work Schedule: Days Hours: 8a-4p Summary: The Manager Government Reimbursement reports to the Director Government Reimbursement and Managed Care.… more
- CHS (Clearwater, FL)
- …One core service, claims administration, is where submissions for payment/ reimbursement /sharing from medical providers and covered individuals are reviewed, subject ... as transparency in reporting results, trends and issues to Senior Management and clients. * Management of relationships with...Examiner queues waiting to be adjudicated, and in either audit or needing approval status. * Developing and implementing… more
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