- Hartford HealthCare (Farmington, CT)
- …are top priority and time sensitive; Centers for Medicare & Medicaid Services (CMS) Recovery Audit Contractor ( RAC ), Executive Health Resources (EHR), ... and payer medical record audits. Provides oversight for designated regulatory audit activity throughout HHC HIM. Oversees and monitor payment protocol through… more
- HCA Healthcare (Brentwood, TN)
- …criteria is met in compliance with departmental policies and procedures + Review Medicare Recovery Audit Contractor ( RAC ) recoupment requests and process ... or appeal as appropriate + Compose technical denial arguments for reconsideration, including both written and telephonically + Overcome objections that prevent payment of the claim and gain commitment for payment through concise and effective appeal argument +… more
- Celestica (Maple Grove, MN)
- …and partners, and ensuring compliance with regulatory requirements (FDA, ISO, ASQ, RAC ). The position is virtual, offering competitive compensation and career growth ... customer surveys, operational reviews, and system applications. * Cultivate an " audit -ready" culture and direct the Global Regulatory Compliance Audit … more
- Insight Global (Sandy Springs, GA)
- …for ISO 27001 certification. * Support internally built tool, Risk and Control ( RAC ) Salesforce application enhancement project. * Assume business owner duties for ... RAC application, including management and monitoring of application fixes...related field). * 4+ years' progressive experience in IT audit (internal/external), internal control, or related areas. * Professional… more
- Vestis Services (Roswell, GA)
- …+ Oversee complex installation, configuration, upgrades, and patching, including Oracle RAC clusters and Microsoft SQL Server HA clusters. + Develop and ... implement advanced high-availability (HA) and disaster recovery (DR) strategies aligned with business needs. + Design...Security and Compliance:** + Partner with internal and external audit teams to ensure compliance with SOX (Sarbanes-Oxley Act)… more
- Community Health Systems (Franklin, TN)
- …The DRG Denials Auditor conducts hospital inpatient DRG denial audits for both RAC and non- RAC accounts, reviewing patient records for accuracy in ICD-10-CM/PCS ... to payers with a strong attention to detail. Additionally, the auditor provides audit feedback to relevant parties, including coders and coding managers, to improve… more
- BD (Becton, Dickinson and Company) (San Diego, CA)
- …insight/guidance during CDx / Pharma partner cross-functional meetings + Provides audit support as needed. + Leads implementation of department procedures and ... the Drug and Device Development and Commercialization process. + RAC Certification is a plus. + Good understanding of...the Drug and Device Development and Commercialization process. + RAC Certification is a plus. + Flow cytometry experience… more
- UL, LLC (Allentown, PA)
- …+ Assess and report in accordance with UL, industry scheme, and client audit protocols on facilities working and/or operational conditions as it relates to ... Nutritional Supplements: 21CFR111 + Medical/Homecare Devices: 21CFR820 + Cosmetics: ISO22716 + Complete audit agendas within 14 calendar days of the audit +… more
- Highmark Health (Helena, MT)
- …entities in response to external coding audits conducted by the Medicare Administrative Contractor , the RAC , MIC, ZPIC, etc. Determine appeal action, prepare ... OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and… more
- Trinity Health (Langhorne, PA)
- …Maintains database of duplicate and overlay corrections for reporting purposes 11. Assists with RAC and other audit activity by entering needed data to track ... 4. Selects appropriate or defined sample size to support audit validity 5. As directed, performs audit ...support audit validity 5. As directed, performs audit of metadata to detect potential privacy breeches related… more
- Sanofi Group (Morristown, NJ)
- …and maintain global governance frameworks, including SOPs, KPIs, change controls, and audit readiness protocols. + Chair and lead the Global Artwork Community of ... performance reviews with key stakeholders and senior leadership. + Maintain audit trails, compliance logs, and reporting dashboards to ensure transparency and… more
- Eastern Connecticut Health Network (Vernon, CT)
- …Payer audits that include but is not limited to Additional Documentation Requests (ADR), Recovery Audit Contractors ( RAC ), and Third-Party Liability (TPL). + ... Administrator to coordinate department activities. Supports the department's efforts to audit , track and trend patient outcomes, analyzes data, develops and… more
- Lockheed Martin (Grand Prairie, TX)
- …commitments \-Participating in independent reviews, including Readiness Acceptance Check \( RAC \), customer proposal reviews, and audits \-Partnering with customers, ... Systems/Models such as Capability Maturity Model Integrated \(CMMI\), QMS System Audit \(AS9100, ISO9001\), AS9145 Desire and ability to implement creative… more
- Haleon (Warren, NJ)
- …+ Providing new or revised labeling + Assisting with special requests including audit and inspection support + Assisting in reviewing content and verifying accuracy ... + Advanced degree in project management, business, quality or scientific disciplines; RAC + Experience working on global teams + Project management experience +… more
- SAIC (Ashburn, VA)
- …The ideal candidate will also have hands-on experience with failover and recovery , backups, migration of on-premises databases to AWS, and proficiency with AWS ... to optimize the application interaction with Graph databases. + Failover and Recovery : Design and execute database backup and recovery strategies, including… more
- Actalent (St. Paul, MN)
- …application of external standards across all projects. + Maintain complete, audit -ready regulatory documentation and manage global submission packages. + Direct ... + Experience presenting regulatory milestones and risk assessments at the board level. + RAC certification or equivalent is a plus. Work Environment This is a hybrid… more
- SAIC (Ashburn, VA)
- …The ideal candidate will also have hands-on experience with failover and recovery , backups, migration of on-premises databases to AWS, and proficiency with AWS ... teams to optimize the application interaction with NoSQL. + Failover and Recovery : Design and execute database backup and recovery strategies, including… more
- Diversicare Healthcare Services & Diversicare Ther (Jackson, MS)
- …Care processes 4. Utilize Electronic Health Record and other available data systems to audit and monitor integrity of: + PDPM HIPPS modifier trends + RUG Trends in ... in teaching/training preferred. 5. Computer skills necessary. 6. Must obtain AANAC RAC -CT certification within 1 year of acceptance of position or Relias CMAC… more
- Mohawk Valley Health System (Utica, NY)
- …procedure codes, for accurate and timely billing of most appropriate payer + Audit charges and establish proper coding in collaboration with providers + Initiate and ... departments with diagnostic and procedural coding + Respond to Insurance, compliance and RAC denials + Review and assist in the maintenance of coding related… more
- Air National Guard Units (Camp Murray, WA)
- …and Extinguisher Maintenance Program. Implements internal controls, self-inspection, and audit compliance. Coordinates with the Base Civil Engineer and other ... Jackets include information on hazards, pre-fire plans,risk assessment codes ( RAC ), and regularly scheduled and special inspections conducted.Documentation includes… more