- Locations: New York, Ohio, Kentucky, Florida, New Mexico
- Related Keywords: Adjustment, Audit, Risk, Risk Adjustment
- Ingenix Vice-President Research & Analytics - telecommute available
- UnitedHealth Group (Eden Prairie, MN)
- ...Recovery, Claims Editing, Subrogation, Fraud and Abuse, Hospital Bill, Audit and Recovery and finally, Coordination of Benefits. Together, we...is required. Superior data analysis skills and knowledge of risk adjustment , grouping methodologies, and statistical analysis will...
- VP-MBS Product Controller
- Barclays Capital (New York, NY)
- ...sheet. MBS Product Control accomplishes this through data validation and adjustment , price verification, provisioning, profit and loss analysis and reporting....also plays a major role in new business, regulatory / audit related reviews and risk calculation and reporting....
- Risk Adjustment Financial Manager
- Aetna (Hartford, CT)
- ...and hourly workers, health plans and government-sponsored plans.Visit our Website Risk Adjustment Financial Manager Report It job description...the year. Individual will also be responsible for overseeing all audit activity of the department from internal organizations, as well...
- Risk Adjustment Financial Manager
- Aetna (Hartford, CT)
- ...a matrix team of different levels of skills. The Revenue Risk adjustment Manager is accountable for the effective development...the year. Individual will also be responsible for overseeing all audit activity of the department from internal organizations, as well governmental...
- Provider Education Specialist
- HealthSpring, Inc. (Nashville, TN)
- ...and guidelines. Familiarity with physician-specific regulations and polices related to documentation and coding. Knowledgeable of Medicare Risk Adjustment . Prior audit /quality experience. Prior experiences teaching/training others on correct coding guidelines and/or have the...
- Mgr Performance Audit , Medicare Risk
- WellPoint (Worthington, OH)
- Title: Mgr Performance Audit , Medicare Risk -42958 Location: OH-Worthington Primary Location: Worthington, OH Work...located in Worthington, travel would be minimal. Responsible for Medicare Advantage Risk Adjustment / Revenue Enhancement department policies and procedures and...
- Mgr Performance Audit , Medicare Risk
- WellPoint (Worthington, OH)
- ...If located in Worthington, travel would be minimal. Responsible for Medicare Advantage Risk Adjustment / Revenue Enhancement department policies and procedures and for directing performance audit activities for CMS, delegated entities/ vendors and internal areas that may include...
- Business Risk Auditor
- April International Inc (New York, NY)
- ...reviews of new products, and incident investigations.Principal Responsibilities ? Business Risk Audit Associate: The Associates in Internal ... analytics, risk models, internal credit ratings, counterparty risk assessment, credit valuation adjustment , risk ...
- Nurse Auditor HCC Integrity Unit-PAC-Full Time
- Presbyterian Health Services (Albuquerque, NM)
- ...of hire to include both as a Certified Medical Audit Specialist [or other nationally recognized nurse auditor certification], and...Condition Categories (HCC) conditions that are applicable to Medicare Risk Adjustment reimbursement initiatives. . Identifies members with...
- Financial Compliance Analyst(Senior Financial Comp
- Sound Transit (Seattle, WA)
- ...audits, reviews, and business process analysis; prepare annual and rolling audit plan; identify areas of risk in order to...and notify appropriate staff; assist in the development, modification or adjustment of policies and procedures. * Prepare and maintain a variety...
- VP-MBS Product Controller
- Barclays Capital (NY)
- ...sheet. MBS Product Control accomplishes this through data validation and adjustment , price verification, provisioning, profit and loss analysis and reporting....also plays a major role in new business, regulatory / audit related reviews and risk calculation and reporting....
- VP-MBS Product Controller
- Barclays Capital (New York, NY)
- ...sheet. MBS Product Control accomplishes this through data validation and adjustment , price verification, provisioning, profit and loss analysis and reporting....also plays a major role in new business, regulatory / audit related reviews and risk calculation and reporting....
- Provider Network Consultant
- Humana (Dallas, TX)
- ...audits, Diagnosis-Related Group audits, and Skilled Nursing Facility audits Develop audit tools and conduct reviews at providers' offices Act as a...of diagnosis information submitted on claims/encounters for the purposes of risk adjustment Use your claims knowledge to build a...
- Certified Coder Consultant
- Humana (Louisville, KY)
- ...audits, Diagnosis-Related Group audits, and Skilled Nursing Facility audits Develop audit tools and conduct reviews at providers' offices Act as a...of diagnosis information submitted on claims/encounters for the purposes of risk adjustment Use your claims knowledge to build a...
