- Elevance Health (Atlanta, GA)
- ** Audit & Reimbursement Senior ** _Location:_ This role enables associates to work virtually full-time, with the exception of required in-person training ... and Medicaid Services to transform federal health programs._ The ** Audit and Reimbursement Senior ** will...report reopenings. + Manage caseload of Medicare cost report Appeals + Position papers + Jurisdictional Reviews + PRRB… more
- Trinity Health (Columbus, OH)
- …a wide variety of professional roles including information technology, financial analysis, audit , provider relations and more. **Position Purpose:** The Appeals ... and Grievance Coordinator is responsible for the processing and resolution of appeals , grievances and disputes from members and providers **What You Will Do:** +… 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
- UPMC (Pittsburgh, PA)
- …third-party cost reports and assist reimbursement teams across UPMC facilities. + ** Audit Defense & Appeals :** Review audit adjustments, prepare ... drive impactful decisions? UPMC Corporate Finance is seeking a ** Senior Reimbursement Analyst** to join our dynamic...of cost report tools and maintain version backups for audit and appeal readiness. + **Ensure Financial Integrity:** Analyze… 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
- Presbyterian Homes and Services (Roseville, MN)
- …resident's stay. + Audit RUG grouper/MDS end splits, review all expedited appeals and ALJ level appeals . Perform concurrent MDS review to assure appropriate ... working knowledge of the RAI process + Experience with MDS completion, reimbursement , clinical resource utilization and/or case management + Ability to work flexible… 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
- LA Care Health Plan (Los Angeles, CA)
- …setting. Experience in health care auditing and monitoring (preferably in Appeals , Grievances, Quality Improvement, Utilization Management (UM) and so forth) and ... developing audit tools. Demonstrated experience developing and delivering training programs...to state/federal sanctions and fines- communicate required action to senior management/Board of Governor (BoG), Plan Partner staff. 2.… 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
- Toyota (Plano, TX)
- …in a large to medium-sized corporate tax department. + Public accounting audit /tax experience and public accounting tax senior manager level experience, ... and Finance Division is looking for a highly motivated and qualified Senior Manager - International Tax Planning. The primary responsibility of this "Director… more
- LifePoint Health (Richlands, VA)
- …Program - mental, physical, and financial wellness assistance * Tuition Reimbursement /Assistance for qualified applicants * Employee discount program * And much ... the Operations Team, provides quality data as available to Senior Management. * Provides data for analysis, in the...on the Corporate Portal * Acts as facility Recovery Audit Coordinator. Ensures completion within the regulated time frame… more