- Elevance Health (Woodlawn, MD)
- …and Medicaid Services to transform federal health programs. The ** Audit and Reimbursement II ** will support our Medicare Administrative Contract (MAC) ... ** Audit & Reimbursement II **...** Audit & Reimbursement II ** **Location:** This role enables...supervision, the Audit and Reimbursement II will gain experience on the Medicare … more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... that purpose. Job Summary The Customer Solution Center (CSC) Audit Readiness Specialist II is responsible for...(DHCS), Department of Public Social Services (DPSS), Centers for Medicare and Medicaid Services(CMS), LACC - CalHers, and National… more
- Ventura County (Ventura, CA)
- …is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare , and general ... in professional medical billing, including billing in Medi-Cal, Commercial Insurance, Medicare and/or chemotherapy and using medical reimbursement programs.… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Association, the Food and Drug Administration (FDA), and Centers for Medicare and Medicaid Services (CMS). Provides routine interaction and coordination with ... accurate and up-to-date knowledge of all Government Programs regulations (Medicaid, Medicare , Federal Employee Program, New York State Department of Financial… more
- The County of Los Angeles (Los Angeles, CA)
- …procedures concerning program administration, ensuring compliance with Federal and State Medicare and Medicaid regulations for reimbursement claiming and maximum ... MENTAL HEALTH PROGRAM MANAGER II / EMERGENCY APPOINTMENTS HOMELESSNESS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4659662) Apply MENTAL… more
- Bassett Healthcare (Sherburne, NY)
- …the best quality of life possible. What you'll do The Ambulatory Office Assistant II serves as the first point of contact for patients within the Bassett Healthcare ... and is entered or scanned into the system accurately as monitored by system audit + Accurate confirmation of attending PCP and Billing PCP, when appropriate. +… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …read assignments. May support vendor discussions and feedback related to quality audit findings. Presents results and learning opportunities to the team. * Serves ... and audits utilizing knowledge and experience of ICD-9-CM/ICD-10-CM coding, Medicare Advantage and Commercial Hierarchical Condition Category (HCC) coding, and… more
- Community Health Systems (Birmingham, AL)
- …insurance reimbursement required + 0-1 years of experience with Medicare preferred **Knowledge, Skills and Abilities** + Advanced knowledge of medical billing ... robust benefits package which may include health insurance, 401(k), licensure/certification reimbursement , tuition reimbursement , and student loan assistance for… more
- University of Rochester (Rochester, NY)
- …equity considerations._ **Responsibilities:** GENERAL PURPOSE The Compliance Analyst II conducts investigations, risk assessments, and regulatory monitoring to ... or reputational risk. **There are two pathways for the Compliance Analyst II (1: Compliance Billing, Coding, and Education Analyst,** **or** **2: Compliance… more
- UPMC (Pittsburgh, PA)
- UPMC Corporate Revenue Cycle is hiring a DRG Specialist II to join our coding team! This opportunity works Monday through Friday during daylight hours. The position ... will be fully remote! In this role, the DRG Specialist II will review clinical documentation within the medical record to ensure that all patient resource… more
- Bassett Healthcare (Cooperstown, NY)
- …the best quality of life possible. What you'll do The Medical Office Assistant II serves as the first point of contact for patients within the Bassett Healthcare ... and is entered or scanned into the system accurately as monitored by system audit + Accurate confirmation of attending PCP and Billing PCP, when appropriate. +… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …function ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. The primary function of ... this position is to perform ICD-10-CM, CPT and HCPCS coding for reimbursement through documentation review as well as abstracting billable services from… more
- Ventura County (Ventura, CA)
- …is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare , and general ... $.69 per hour (Level I), $1.00 per hour (Level II ), or $1.32 per hour (Level III). + Vacation...Reviews bulletins to identify new programs that may affect reimbursement for Medi-Cal and/or Medicare and prepares… more
- Medical Mutual of Ohio (OH)
- …Set (HEDIS) lifecycle processes for all lines of business (Commercial, Marketplace, Medicare Advantage, and Medicaid), including HEDIS audit submission, Consumer ... insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Supports corporate and… more
- The County of Los Angeles (Los Angeles, CA)
- …for permanent appointment to Health Care Financial Analyst. DEFINITION: Prepares reimbursement claims for health and/or mental health care provided under Federal, ... of program and financial reports. Essential Job Functions + Analyzes reimbursement requirements for Federal, State, and/or Special Programs to determine if… more
- Highmark Health (Nashville, TN)
- …OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and ... coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure… more
- Bassett Healthcare (Hamilton, NY)
- …and is entered or scanned into the system accurately as monitored by system audit + Accurate confirmation of attending PCP and Billing PCP, when appropriate. + ... of Advanced Beneficiary Notice signatures and form processing to meet Medicare regulations. + Ensures all corrections (demographics, insurance eligibility etc.)… more
- The County of Los Angeles (Los Angeles, CA)
- …patients and our communities by providing extraordinary care. DEFINITION: Prepares reimbursement claims for health and/or mental health care provided under Federal, ... production of program and financial reports. Essential Job Functions Analyzes reimbursement requirements for Federal, State, and/or Special Programs to determine if… more
- The County of Los Angeles (Los Angeles, CA)
- …and procedures concerning administration, ensuring compliance with Federal and State Medicare and Medicaid regulations for reimbursement claiming and maximum ... review methods as necessary. + Oversees audits and the implementation of audit recommendations for programs managed. + Represents managed programs in meetings with… more
- The County of Los Angeles (Los Angeles, CA)
- …appointment to Health Care Financial Analyst. Essential Job Functions Analyzes reimbursement requirements for Federal, State, and/or Special Programs to determine if ... claims for reimbursement conform to applicable rules and regulations and result...and regulations and result in maximum revenue collection. Prepares Medicare and Medi-Cal cost reports and State mandated disclosure… more