- Benedictine (Rochester, MN)
- …and reports any outstanding departments or issues. Participate in internal reimbursement audit processes as assigned. Performs other duties, tasks and/or projects as ... Medicare, assessment, and care-planning processes QUALIFICATIONS PREFERRED AANAC Certification RAC -CT CPR Certified EEO/AA/Vet Friendly Salary Range $40-$45 an hour… more
- HCA Healthcare (Dallas, TX)
- …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
- 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
- Elderwood (Buffalo, NY)
- …and integrity of clinical reimbursement data and billing processes. + Audit MDS coding and supporting documentation; identify opportunities for improvement. + ... the Elderwood network. What We're Looking For: + Active RN license (required). + RAC -CT certification preferred. + Minimum of 5 years of MDS experience in a skilled… more
- Watco Companies LLC (Pittsburg, KS)
- …advancement opportunities Starting Hourly Rate: $21.00 A Revenue Accounting Clerk ( RAC ) is responsible for assisting in capturing revenue timely and accurately ... able to understand how the revenue is applied. The RAC will be able to answer basic revenue related...regarding the location(s) in which they are required to audit . Job Duties + Read and understand tariff and… more
- LifePoint Health (Rutherfordton, NC)
- …discharge plans.5. Follows up with any denials through the appeals process; including RAC chart audit reviews. Emergency Department (ED) Case Management1. Serves ... and assure documentation meets Medicare requirements to reduce the risk related to RAC 's.5. Documentation in the medical records is completed in the appropriate time… more
- UNC Health Care (Morrisville, NC)
- …standards such as CPT coding guidelines and CMS policies. Assists in preparing annual audit and work plan. Performs work outlined in work plan. Obtains and analyzes ... Assists in development of new policies and procedures and audit tools. Performs E/M and Procedural coding audits. Analyzes...and ensures correct coding and billing compliance. Assists with RAC audits and review of other outside requests as… more
- Highmark Health (Harrisburg, PA)
- …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
- 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 ... 21CFR111 + Medical/Homecare Devices: 21CFR820 + Cosmetics: ISO22716 #MB-1 #LI-Remote Complete audit agendas within 14 calendar days of the audit Complete… more
- Sharp HealthCare (San Diego, CA)
- …is responsible for the administration of the Sharp HealthCare's (SHC's) compliance audit program. The position provides oversight and maintenance of a high-quality, ... effective, best practices coding, billing, and reimbursement audit compliance program to prevent and detect violations of...risk analyzer software, OIG Work plan, CMS, PEPPER Reports, RAC Denials, industry experts, etc. + Policy and Procedure… more
- St. Luke's University Health Network (Allentown, PA)
- …and procedure code assignment and MS-DRG/APR-DRG accuracy based on denials or audit findings from government and commercial payers. Meet or exceed established ... the physician advisor in review of patient medical records identified by RAC /MIC/QIO and other governmental or commercial payor auditors in retrospective reviews for… 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
- St. Luke's University Health Network (Allentown, PA)
- …leadership team. Oversees account changes pertaining to accepted and/or appealed audit recommendations and works with staff assisting with clerical and ... administrative tasks related the appeals/ audit function. Identify and provide feedback, including identification of...advisor in review of patient medical records identified by RAC /MIC/QIO and other insurers or outside auditors in retrospective… more
- Highmark Health (Tallahassee, FL)
- …root cause), monitoring & auditing payer issues and denials, appealing RAC audits and reports that require well-developed analytic and organizational skills, ... and procedures by identifying training and development needs based on audit or workqueue trends. **ESSENTIAL RESPONSIBILITIES** + Reviews, analyzes and resolves… more
- Lockheed Martin (Orlando, FL)
- …of the contract negotiating team and interacting with DCAA and other audit agencies * Initiating process improvements to enhance productivity and efficiency within ... include: \- EPP preparation and presentation \- BOE Development and Generation \- RAC review process \- Proposal strategy and analysis \- Cost volume preparation \-… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- …as needed and make referrals for identified continued care needs. + Support chart audit functions including RAC and third-party requests. + Assist in identifying ... department interventions and priority expectations to improve case management metrics (LOS reduction, Readmission reduction, discharge times, etc.) + Practice autonomously, consistent with practice standards, policy, and procedures. + Escalate cases as needed… more
- Actalent (Irvine, CA)
- …procedures to identify gaps, overlaps, and alignment opportunities for integration and audit readiness. + Migrate documents into systems like Propel and SharePoint, ... or equivalent discipline is required. Additional Skills & Qualifications + RAC Certification is preferred. + Experience with post-market and change management… more
- Catholic Health Initiatives (Bismarck, ND)
- …are being adhered to within the department. Responsible for oversight of the clinic RAC audit releases and requests. + Maintains a cooperative relationship among ... health care teams by communicating information; responding to requests; building rapport; participating in team problem-solving methods. **Qualifications** **Education:** Associates Degree in Health Information Management or a related business degree and… more
- Mohawk Valley Health System (Utica, NY)
- …+ Provide peer-to-peer payor review in collaboration with attending physicians. + Support Recovery Audit Contractors ( RAC 's). + Assist with mitigating ... barriers to discharge and care progression. + Perform concurrent review of cases greater than 4 days or the assigned/estimated GMLOS + Partner with the care management team with the management of LOS, complex care needs and patient throughput efforts. Provide… 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
