- UNC Health Care (Hendersonville, NC)
- …to improve 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… more
- Baptist Memorial (Memphis, TN)
- Overview Coordinator- RAC TPE Job Code: 21540 FLSA Status Job Family: FINANCE Job Summary Medicare / Medicaid Appeals Registered Nurse reviews and evaluates medical ... care experience and 3 years in Medicare billing environment. Previous audit experience, knowledge of InterQual and Medicare Billing practices. Education Description… more
- Nuvance Health (Danbury, CT)
- *Description* *Summary:* *Associate Compliance Officer ("ACO"), Clinical Audit , Quality and Revenue Cycle* Consistent with legal requirements and compliance program ... according to the requirements by Joint Commission; 3.Performs moderately complex clinical audit activities and work assignments under the direction of the the SACO.… more
- Trinity Health (Des Moines, IA)
- …discrepancies with Medical Records Department and Admitting Department. + Collaborates with the Recovery Audit Contractor ( RAC ) Coordinator and Conifer ... for Medicare/Medicaid RAC Denials management. **MINIMUM KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:** + Current licensure as a registered nurse in the State of Iowa. + Five (5) years clinical nursing experience. + Bachelor of Science - Nursing or degree in… more
- Hospice of Michigan (Ann Arbor, MI)
- …complete 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… more
- Catholic Health Initiatives (Omaha, NE)
- …in a data-driven approach + Facilitate pre-payment reviews and/or participating in recovery audit contractor reviews + Assist Hospital Administration ... in billing for the technical component of the services rendered by the Departments, including initial billings, follow-up reports, and appeals in cases of retrospective denials + Assist Hospital Administration and the Medical Staff in connection with any… more
- Ochsner Health (New Orleans, LA)
- …in a data-driven approach + Facilitate pre-payment reviews and/or participating in recovery audit contractor reviews + Assist Hospital Administration ... in appeals process for retrospective denials + Assist Hospital Administration and the Medical Staff in connection with any regulatory audits, investigation, survey, or other review of the Departments + Ensure consistency of utilization review services, quality… more
- Mohawk Valley Health System (New Hartford, NY)
- …internal and external compliance audits for the Mohawk Valley Health System ("MVHS") audit and compliance function under the guidance and direction of the Chief ... + Develop and deliver compliance training based on identified audit findings. + Prepare detailed audit reports...and compile statistical analysis. + Serves as the primary RAC and appeals liaison for the hospital, including preparation… more
- UNC Health Care (Morrisville, NC)
- …standards such as CPT coding guidelines and CMS policies. Assists in preparing annual audit and work plan. Performs work outlined in work plan. Obtains and analyzes ... Assists in development of new policies and procedures and audit tools. Performs E/M and Procedural coding audits. Analyzes...and ensures correct coding and billing compliance. Assists with RAC audits and review of other outside requests as… more
- Highmark Health (Harrisburg, PA)
- …entities in response to external coding audits conducted by the Medicare Administrative Contractor , the RAC , MIC, ZPIC, etc. Determine appeal action, prepare ... OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and… more