- The Cigna Group (Bloomfield, CT)
- …as required, to develop and promote shared goals. The Quality Review and Audit Senior Analyst position recognizes experience in Risk Adjustment Data Validation ... Risk Adjustment (RA) programs, including the Risk Adjustment Data Validation (RADV) audit and the Supplement Diagnosis program. Responsible for liaising with the… more
- Rochester Regional Health (Rochester, NY)
- …to maximize reimbursement . Identifies appeal able items which could enhance reimbursement . Prepares and submits appeals . + Accurately prepares and submits on ... findings. Makes recommendations as to whether the third party audit findings are in compliance with reimbursement ...party audit findings are in compliance with reimbursement regulations. + Accurately calculate and record hospital inpatient… 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
- Movn Health (CA)
- Role Summary Movn Health is seeking a highly experienced Senior Medical Biller & A/R Specialist to take full ownership of claims processing and accounts receivable ... recovery. This is a hands-on, senior -level role focused on accelerating cash flow, reducing outstanding...with a proven track record in A/R recovery, claim appeals , and payer follow-ups. Experience in startup environments and… more
- Trinity Health (Des Moines, IA)
- …identifies and manages all financial and compliance risk associated with the reimbursement function, keeping senior leadership apprised of identified risk and ... reimbursement function (for acute and professional services), notifying senior leadership of identified risks and tracking and monitoring...party audits and takes a lead role in resolving audit issues and developing appeals . Directs the… 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
- Iowa Department of Administrative Services (Des Moines, IA)
- …of Public Safety (DPS) is seeking to fill aRetirement Benefits Officer Senior position within the Administrative Services Division. This position is responsible for ... based on Chapter 97A. Research requests for medical cost reimbursement from disability retirees, including prescription drugs and medical...and for the State of Iowa's CAFR. Coordinate annual audit of program by the Auditor of State of… 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
- Houston Methodist (Houston, TX)
- …Medicare cost report for each HM hospital and assists in cost report amendments, audit , appeals and reopening process. + Independently prepares federal and state ... At Houston Methodist, the Senior (Sr.) Accountng and Reporting Analyst position is...compiling information to effectively report costs and seek maximum reimbursement from various government programs. The Sr. Accounting and… more
- Whitney Young Health Center (Albany, NY)
- …and vision insurance, 401k with safe harbor employer match, tuition reimbursement , term life insurance, commuter benefits and more! GENERAL RESPONSIBILITIES:The ... for WYH and Equinox, including direct mail and online appeals , grants and events + Manage and enhance existing...regular reports on progress against planned goals + Oversee, audit and comply with gift processing practices and policies… more