- Duck River Electric Membership Corporation (Arlington, VA)
- …reinsurance, PPO networks, vision insurance, transplant services, population health, Medicare exchange, overpayment recovery , wellness programs, and COBRA ... focused on delivering high-quality, actionable, and thoughtful legal, compliance and audit services across NRECA's broad product and service offerings. This position… more
- NRECA (Arlington, TX)
- …reinsurance, PPO networks, vision insurance, transplant services, population health, Medicare exchange, overpayment recovery , wellness programs and COBRA ... focused on delivering high-quality, actionable and thoughtful legal compliance and audit services across NRECA's broad product and service offerings. This position… more
- HCA Healthcare (Ocala, FL)
- …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
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** The Manager, Medicare Claims, oversees end-to-end claims services for provider segments, meeting business goals. This role sets performance ... standards. + Participate in projects to improve and/or facilitate claims processing, recovery , and accounting functions. + Manage financial recovery activities… 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
- Molina Healthcare (Cedar Rapids, IA)
- JOB DESCRIPTION Job Summary Provides support for claims recovery activities including researching claim payment and billing guidelines, audit results, and ... and provider compliance. Collaborates with health plans and vendors to facilitate recovery of outstanding overpayments. Monitors and controls backlog and workflow of… more
- Saint Francis Health System (Tulsa, OK)
- …to enhance audits and provides continuous monitoring. Provides oversight to sales tax recovery for taxable items utilized directly on Medicare and Medicaid ... assistance is available to support the transition. Job Summary: The Senior Internal Audit Analyst plays a critical role in evaluating and improving the effectiveness… more
- Stanford Health Care (Palo Alto, CA)
- …complete and accurate capture of all legitimate reimbursement opportunities. + Oversee Medicare and Medi-Cal audit processes, addressing inquiries and pursuing ... and regulatory reports to government agencies, including but not limited to: * Medicare and Medi-Cal cost reports *Financial disclosures to the Department of Health… more
- Stanford Health Care (Palo Alto, CA)
- …billing, including federal and state regulations and guidelines, CMS (Centers for Medicare and Medicaid Services) and OIG (Office of Inspector General) compliance ... + Conducts defensive charge audits, self-pay/patient requests, or other special audit projects, as requested, comparing itemized bills to corresponding medical… more
- NHS Management, LLC (Daytona Beach, FL)
- …offers you the unique opportunity to walk alongside patients on their road to recovery from many different conditions. As you care for and help patients achieve ... with internal controls and state and federal regulations. + Ability to audit resident accounts, assess accuracy and collectability of accounts receivable balances,… more
