- Elevance Health (Columbus, OH)
- ** Audit & Reimbursement Senior - Medicare Cost Report Audit ** **_Location: This is a virtual position, the ideal candidate will live within 50 miles ... Services to transform federal health programs. The ** Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) with the… more
- AdventHealth (Altamonte Springs, FL)
- …**Job Location** : Hybrid; Altamonte Springs, FL **The role you'll contribute:** The Senior Reimbursement Analyst is responsible for preparing and filing the ... third party balances of AdventHealth + Review the reasonableness of hospital interim reimbursement rates and special payments received from Medicare and Medicaid… more
- The Cigna Group (Bloomfield, CT)
- **Remote, work from home - United States** **Summary** The Business Analytics Senior Advisor position within the Medicare Growth Analytics Team is an opportunity ... to provide leadership on our analytics strategy, to support our broader Medicare Growth team and provide actionable insights and analytics. This role will work with… more
- PruittHealth (Norcross, GA)
- **JOB PURPOSE:** Supports the delivery of all Medicare billing services by final/higher level auditing, correcting, and submitting claims. Ensures that billing ... services are timely, accurate, and allow for appropriate reimbursement . Conducts all claims-related follow up on payment delays,...standards, are familiar with the rules and regulations of Medicare billing and are skilled at problem solving and… more
- Fairview Health Services (Minneapolis, MN)
- **Overview** We at Fairview Health Services are seeking a driven Senior Financial Analyst to work in the Solid Organ Transplant specialty department! This position ... whom are non-MN residents are welcome to apply. The Senior Financial Analyst will serve as the Solid Organ...and financial implications of the Transplant components of the Medicare Cost Report (MCR). **Responsibilities Job Description** The Sr… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …staff, Benefits Administration staff, Provider Audit , Network Administration and/or Medicare Advantage staff, and entry level Reimbursement Analyst by ... Medicare Advantage must have working knowledge of Medicare enrollment guidelines and reimbursement . **Licenses and...well as coordinating projects and time frames with less senior reimbursement staff. + Accountable for complying… more
- AdventHealth (Altamonte Springs, FL)
- …Hybrid **Job Location** : Altamonte Springs, FL **The role you'll contribute:** The Senior Reimbursement Analyst is responsible for preparing and filing the ... third party balances of AdventHealth . Review the reasonableness of hospital interim reimbursement rates and special payments received from Medicare and Medicaid… more
- University of Michigan (Ann Arbor, MI)
- Reimbursement Analyst Senior Apply Now **How to Apply** A cover letter is required for consideration for this position, and it should be attached as the first ... leadership, affiliated hospitals, payers, outside agencies and government entities. The reimbursement analyst will maintain current knowledge of Medicare ,… more
- Prime Healthcare (Ontario, CA)
- …preparation of various government reports and support their audits. The Corporate Senior Government Reimbursement Specialist is responsible for preparing and ... understanding the complexity of a cost report. The Corporate Senior Government Reimbursement Specialist fully understands how...a multi-state hospital system and provide the support at audit + Knowledge of Medicare rules on… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …under the direction of the departmental director and working closely with more senior level reimbursement staff. May serve on related committees. + Identifies ... hoc requests such as auditing of contracts, responses to RFI/RFPs, researching Medicare and other industry policies and reimbursement methodologies. Compiles fee… more
- Bausch Health (Bridgewater, NJ)
- …of improving people's lives with our health care products. Reporting to the Senior Director, Finance (Revenue & GTN Accounting), the Senior Manager, Finance ... is responsible for managing and accounting for Commercial and Medicare Part D contracts and will oversee the daily...environment including the maintenance of the risk control matrix, audit support, and the periodic SOX sub-certification. + Lead… more
- Centene Corporation (Columbus, OH)
- …Responsible for the development and implementation of the health plan's compliance audit work plan. Completes Prospective and retrospective audits on a monthly, ... + Identify regulatory oversight deficiencies, process gaps and communicate audit observations, analyzes findings to provide recommendations on process improvements… more
- CommonSpirit Health (Phoenix, AZ)
- …happen both inside our hospitals and out in the community. **Responsibilities** The ** Senior Reimbursement Analyst i** s responsible for providing cost report ... preparation, cost report appeals, audit preparation and other duties...the improvement of internal business processes and meeting future reimbursement service needs. The Senior Reimbursement… more
- The Cigna Group (Bloomfield, CT)
- …AND TAMPA** **Job Summary:** This role is responsible for supporting Cigna Medicare Advantage's Risk Adjustment & Stars program for assigned populations in an ... to assigned providers and internal matrix partners of Cigna Medicare 's programs specific to CMS Risk Adjustment and HCC...and efficient. + Review and act on any assigned audit educational opportunities timely and provide primary care or… more
- The Cigna Group (Bloomfield, CT)
- …addition to base salary._** This role is responsible for supporting Cigna Medicare Advantage's Risk Adjustment program for assigned populations in an operational ... to assigned providers and internal matrix partners of Cigna Medicare 's programs specific to CMS Risk Adjustment and HCC...and efficient. + Review and act on any assigned audit educational opportunities timely and provide primary care or… more
- Brookdale Senior Living (Brentwood, TN)
- …with us for at least a year. Responsibilities The Director of Clinical Reimbursement is responsible for the oversight of Medicare /Medicaid/Managed Care ... offered include, but are not limited to: + Tuition Reimbursement + Pet Insurance + Adoption Reimbursement ...to CMS and PDPM. + Oversees reporting systems to audit facility MDSs and determine modifications needed as appropriate,… more
- Guidehouse (Hanover, MD)
- …field of study + Minimum of 3+ years of relevant experience working in Audit /Compliance or Finance **What Would Be Nice To Have** **:** + Experience working with ... CMS (Centers for Medicare & Medicaid) + Knowledge of financial instruments including...credit + Ability to gather, analyze, design, and implement Compliance/ Audit Plans + Ability to leverage technology to create… more
- Banner Health (AZ)
- …collaborating with many areas such as Billing, Coding, CDM Services Expected reimbursement . The Senior Cardiology and Interventional Radiology Certified Coder's ... gain greater visibility for sound financial outcomes/practices, compliance and optimal reimbursement with focus across all continuums of patient care. Revenue… more
- CVS Health (Cumberland, RI)
- …Insurance Portability and Accountability Act (HIPAA) and the Centers for Medicare and Medicaid Services (CMS) guidelines to mitigate organizational compliance risks. ... payments, sales records, service agreements, and contracts to provide a reliable audit trail for potential disputes or inquiries. + Coordinates with external… more
- Providence (WA)
- …and retain the best people, we must empower them._** **Providence is calling a Senior Coding Quality Educator who will:** + Assist with the day-to-day operations of ... of new service offerings or code changes + Facilitates education to support Medicare Risk requirements & organization goals + Review relevant patient details from… more