• Medicaid Integrity Specialist 1/Trainee 1/Trainee…

    New York State Civil Service (Albany, NY)
    …& Payment Oversight. Duties include but are not limited to:-Collaborate closely with the Recovery Audit Contractor ( RAC ) to facilitate reviews through ... the new Draft Audit Report (DAR) and Final Audit Report (FAR) procedures.-Contacting appropriate internal OMIG stakeholders and external stakeholders for… more
    New York State Civil Service (07/11/25)
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  • Clinical Denials Coding Review Specialist

    HCA Healthcare (Dallas, TX)
    …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
    HCA Healthcare (07/19/25)
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  • Physician Advisor

    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
    Catholic Health Initiatives (06/20/25)
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  • Principal Oracle Database Engineer

    Vestis Services (Roswell, GA)
    …+ Oversee complex installation, configuration, upgrades, and patching, including Oracle RAC clusters and Microsoft SQL Server HA clusters. + Develop and ... implement advanced high-availability (HA) and disaster recovery (DR) strategies aligned with business needs. + Design...Security and Compliance:** + Partner with internal and external audit teams to ensure compliance with SOX (Sarbanes-Oxley Act)… more
    Vestis Services (07/08/25)
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  • Regional MDS Coordinator (RN)

    Elderwood (Buffalo, NY)
    …and integrity of clinical reimbursement data and billing processes. + Audit MDS coding and supporting documentation; identify opportunities for improvement. + ... the Elderwood network. What We're Looking For: + Active RN license (required). + RAC -CT certification preferred. + Minimum of 5 years of MDS experience in a skilled… more
    Elderwood (07/02/25)
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  • Revenue Account Clerk

    Watco Companies LLC (Pittsburg, KS)
    …advancement opportunities Starting Hourly Rate: $21.00 A Revenue Accounting Clerk ( RAC ) is responsible for assisting in capturing revenue timely and accurately ... able to understand how the revenue is applied. The RAC will be able to answer basic revenue related...regarding the location(s) in which they are required to audit . Job Duties + Read and understand tariff and… more
    Watco Companies LLC (06/27/25)
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  • Clinical Case Manager

    LifePoint Health (Rutherfordton, NC)
    …discharge plans.5. Follows up with any denials through the appeals process; including RAC chart audit reviews. Emergency Department (ED) Case Management1. Serves ... and assure documentation meets Medicare requirements to reduce the risk related to RAC 's.5. Documentation in the medical records is completed in the appropriate time… more
    LifePoint Health (06/09/25)
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  • Coding Auditor Educator

    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
    Highmark Health (07/16/25)
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  • Lead Auditor CRS

    UL, LLC (Allentown, PA)
    …+ Assess and report in accordance with UL, industry scheme, and client audit protocols on facilities working and/or operational conditions as it relates to ... 21CFR111 + Medical/Homecare Devices: 21CFR820 + Cosmetics: ISO22716 #MB-1 #LI-Remote Complete audit agendas within 14 calendar days of the audit Complete… more
    UL, LLC (07/03/25)
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  • Compliance Coding Auditor

    Sharp HealthCare (San Diego, CA)
    …is responsible for the administration of the Sharp HealthCare's (SHC's) compliance audit program. The position provides oversight and maintenance of a high-quality, ... effective, best practices coding, billing, and reimbursement audit compliance program to prevent and detect violations of...risk analyzer software, OIG Work plan, CMS, PEPPER Reports, RAC Denials, industry experts, etc. + Policy and Procedure… more
    Sharp HealthCare (07/13/25)
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