- Stanford Health Care (Palo Alto, CA)
- …the Revenue Cycle Denials Management Department by managing and resolving clinical appeals related to government audits and denials. This position requires strong ... analytical and communication skills. The Clinical Government Audit Analyst and Appeals Specialist II will collaborate with clinical staff, coding professionals, and… more
- Stanford Health Care (Palo Alto, CA)
- …and regulatory reports to government agencies, including but not limited to: - Medicare and Medi-Cal cost reports -Financial disclosures to the Department of Health ... timely and accurate filing of annual government cost reports, including Medicare , Medi-Cal, and HCAI submissions. + Maintain comprehensive knowledge of federal… more
- Stony Brook University (East Setauket, NY)
- …business functions including but not limited to: billing, claims analysis appeals , follow-up, financial assistance and customer service. **Duties of a Revenue ... on rejected or denied claims, improper payments and coding issues. + Process appeals . + Liaise with third party billing and collection agencies. + Identify issues… more
- Sun Pharmaceuticals, Inc (Washington, DC)
- …in access and reimbursement issues encompassing coverage, prior authorizations, appeals , exceptions, denials, coding and payer payment guidelines, payer policies, ... care to support patient options. + Possess expertise in Medicare policies and the variations within all parts of... policies and the variations within all parts of Medicare + Ensure processes are in place to drive… more
- COOLSOFT (Harrisburg, PA)
- …required. Description : DHS and the HHS DC worked with the Centers for Medicare & Medicaid Services (CMS), and other federal partners responsible for the programs, ... of Long-Term Living (OLTL) - Bureau of Hearings and Appeals (BHA) within the Office of Administration - Office...and Early Learning (OCDEL) - Centers for Medicaid & Medicare Services (CMS) - Administration for Children and Families… more
- Commonwealth Care Alliance (Boston, MA)
- …Referral and authorization; Regulatory compliance; Billing and payments; Complaints and appeals ; Policies and procedures. + Identify opportunities for training and ... + Experience in health plan provider relations. **Experience (Desired)** + Medicare /Medicaid experience preferred. + Experience with CPT coding and authorization… more
- OhioHealth (Columbus, OH)
- …Manager with updates. CGS audits and auditors Working with our legal vendor for Medicare Appeals . Working with OHA and CBSA facilities on wage index ... Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position… more
- Molina Healthcare (Omaha, NE)
- …benefits (COB), subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory ... in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). M-F from 8am - 4:30pm EST will require… more
- Molina Healthcare (Houston, TX)
- …complicated claims, COB and DRG/RCC pricing). * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory ... accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Manages team… more
- Molina Healthcare (Fort Worth, TX)
- …of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory ... with the standards and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research… more
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