- Elevance Health (Columbus, OH)
- ** Audit & Reimbursement Senior ** _Location:_ This role enables associates to work virtually full-time, with the exception of required in-person training ... and Medicaid Services to transform federal health programs._ The ** Audit and Reimbursement Senior ** will...report reopenings. + Manage caseload of Medicare cost report Appeals + Position papers + Jurisdictional Reviews + PRRB… more
- LA Care Health Plan (Los Angeles, CA)
- Senior Health Care Audit Analyst Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... The Specialty Plans Auditor III is responsible for planning audits and audit work programs that address appropriate claims and financial compliance criteria for… more
- Independent Health (Buffalo, NY)
- …correlating coding complexity. They will aid in training other team members, evaluating appeals , and share audit trends across the team. Expertise and ... tips across the team. The Clinical & Coding Specialist- Senior will support the leadership in Hospital Audit...to prepare quantitative and qualitative studies at conclusion of audit . Ability to recalculate reimbursement following conclusion… more
- UPMC (Pittsburgh, PA)
- …third-party cost reports and assist reimbursement teams across UPMC facilities. + ** Audit Defense & Appeals :** Review audit adjustments, prepare ... drive impactful decisions? UPMC Corporate Finance is seeking a ** Senior Reimbursement Analyst** to join our dynamic...of cost report tools and maintain version backups for audit and appeal readiness. + **Ensure Financial Integrity:** Analyze… more
- CommonSpirit Health (Phoenix, AZ)
- **Responsibilities** **Position Summary:** The Senior Reimbursement Analyst is responsible for providing cost report preparation cost report appeals audit ... also assists in the improvement of internal business processes and meeting future reimbursement service needs. The Senior Reimbursement Analyst carries out… more
- CommonSpirit Health (Phoenix, AZ)
- **Responsibilities** The ** Senior Reimbursement Analyst i** s responsible for providing cost report preparation, cost report appeals , audit preparation ... also assists in the improvement of internal business processes and meeting future reimbursement service needs. The Senior Reimbursement Analyst carries out… 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
- Presbyterian Homes and Services (Roseville, MN)
- …resident's stay. + Audit RUG grouper/MDS end splits, review all expedited appeals and ALJ level appeals . Perform concurrent MDS review to assure appropriate ... working knowledge of the RAI process + Experience with MDS completion, reimbursement , clinical resource utilization and/or case management + Ability to work flexible… more
- Centene Corporation (Austin, TX)
- …performance, confirming process validation and compliance with internal and external audit and regulatory requirements. Responsible for the quality assurance process ... products, technology and processes that will enhance overall service + Works with senior management to develop and manage strategic sourcing plans across the company… more
- Somatus (Mclean, VA)
- …Paid Time Off (PTO) + Professional Development, CEU, and Tuition Reimbursement + Curated Wellness Benefits supporting teammates physical and mental well-being ... Need Plans (SNPs). The Director, Quality will work closely with Sr. Manager, Audit Risk and the Regulatory and Accreditation Team to ensure compliance with audits,… more