- University of Virginia (Charlottesville, VA)
- Coordinates all audit activities related to the Medicare Recovery Audit Contractor (RAC) Program, Medicare Administrative Contractor (MAC), ... Error Rate Testing (CERT) reviews, commercial payers, etc. Logs and tracks audit records requests, organizes, coordinates and tracks appeal processes at all levels.… more
- UNC Health Care (Rocky Mount, NC)
- …improve the health and well-being of the unique communities we serve. **Summary:** The Recovery Audit Nurse will work closely with other Business Office staff ... accounts/claims denied payment through retrospective or prospective review, ie - Medicare and Medicaid RA ( Recovery Auditor) programs. **Responsibilities:** +… more
- Trinity Health (Columbus, OH)
- …, a college of nursing (https://www.mccn.edu) , a Medicare Advantage plan (https://www.medigold.com) , and extensive outreach and ... to the charge capture and billing of services. Prepares and submits audit findings, makes recommendations, and works closely with revenue integrity leadership and… more
- ConnectLife (Williamsville, NY)
- …federal, accreditation and processor rules and standards. Perform desk and on-site recovery /acquisition audits to ensure compliance with the recovery of organ, ... assurance experience in a healthcare environment, OPO environment, Tissue Recovery Agency, quality/regulatory affairs, manufacturing and/or process auditing desired.… more
- MetroLink (Los Angeles, CA)
- …of the payables system, taking advantage of system capabilities. + Enter and audit invoices or bills for compliance against purchase orders and requisitions. + Track ... exceeds $50,000, be added to your Federal, State, and Medicare taxable earnings for W-2 reporting. This amount is...of Oracle architecture, advanced topics, high availability and disaster recovery solutions, mentorship.) + None of the above 06… 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
- Bausch Health (Bridgewater, NJ)
- …in Bridgewater, NJ and is responsible for managing and accounting for Commercial and Medicare Part D contracts and will oversee the daily operations of the contract ... + Review and approve rebate claims data received for managed care contracts, Medicare Part D contracts, and other commercial and government programs. Validate rebate… more
- Lakeview NeuroRehabilitation Center (Waterford, WI)
- …heads and participates in strategic planning. + Maintains data for preparation of Medicare cost report. + Prepares audit schedules for financial and program ... accountable for the company's daily accounting function, monthly financial statements, audit procedures and review of internal controls; preparation and review of… more
- Molina Healthcare (Albuquerque, NM)
- …for supporting the prevention, detection, investigation, reporting, and when appropriate, recovery of money related to health care fraud, waste, and abuse. ... coding accuracy and excellence. The position also entails producing audit reports for internal and external review. The position...+ Knowledge of Managed Care and the Medicaid and Medicare programs as well as Marketplace. + Understanding of… more
- New York State Civil Service (Albany, NY)
- …overseeing operational audits or audits of internal controls to develop audit reports and make recommendations to management regarding policies, practices, ... position will perform all the basic contracting functions necessary to access Medicare Advantage plans, Medicaid Managed Care plans, commercial managed care plans,… more
- Kansas Surgery & Recovery Center (Wichita, KS)
- Kansas Surgery and Recovery Center is a leader in providing exceptional patient care. With over 100 physicians performing elective procedures across numerous ... tax payments, and balance sheet account reconciliations. Preparation of audit , cost report and tax work papers is on-going....Thank you for your interest in Kansas Surgery & Recovery Center. We are an equal opportunity employer that… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Additional research will include Agency for Healthcare Research and Quality (AHRQ), Recovery Audit Program (RAC) Statement-of-Work (SOW), Office of Inspector ... performs all related internal, concurrent, prospective and retrospective coding audit activities across the Hackensack Meridian Health (HMH) network. Reviews… more
- Hackensack Meridian Health (Hackensack, NJ)
- …denials by: I. Peer-to Peer (P2P) Concurrent appeals ii. Written Concurrent appeals iii. Recovery Audit Contractors & levels of appeal iv. Root cause analysis & ... status based on length of stay, level of care requirements and Medicare regulations, and Major Complications or Comorbidities (MCC) / Complications or Comorbidities… more