• Audit & Reimbursement II (US)

    Elevance Health (Manchester, NH)
    …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
    Elevance Health (05/30/25)
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  • Audit & Reimbursement II (US)

    Elevance Health (Indianapolis, IN)
    ** Audit & Reimbursement II ** **_Location:_** This...(GAS). The Auditor II will gain experience on Medicare Part A Audit and Reimbursement ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare...and Medicaid Services to transform federal health programs. The ** Audit and Reimbursement II ** ,… more
    Elevance Health (06/06/25)
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  • Customer Solution Center Audit Readiness…

    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
    LA Care Health Plan (05/29/25)
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  • Medical Billing Specialist II - Patient…

    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
    Ventura County (05/29/25)
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  • Compliance Advisor II

    LA Care Health Plan (Los Angeles, CA)
    Compliance Advisor II Job Category: Administrative, HR, Business Professionals Department: Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... safety net required to achieve that purpose. Job Summary The Compliance Advisor II ensures LA Care business units are compliant with all Product Lines' contractual,… more
    LA Care Health Plan (05/30/25)
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  • Mental Health Program Manager II

    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
    The County of Los Angeles (06/01/25)
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  • Ambulatory Office Assistant II - Clinical

    Bassett Healthcare (Cooperstown, 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 ... is entered or scanned into the system accurately as monitored by system audit Accurate confirmation of attending PCP and Billing PCP, when appropriate. Assures… more
    Bassett Healthcare (05/29/25)
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  • HEDIS Abstractor II (Temporary)

    LA Care Health Plan (Los Angeles, CA)
    HEDIS Abstractor II (Temporary) Job Category: Clinical Department: Quality Performance Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... Summary The Healthcare Effectiveness Data and Information Set (HEDIS) Abstractor II reviews medical records to ensure completeness, compliance with National… more
    LA Care Health Plan (04/09/25)
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  • Risk Adjustment Coding Coordinator I/ II

    Excellus BlueCross BlueShield (Buffalo, 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
    Excellus BlueCross BlueShield (05/20/25)
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  • Medical Office Assistant II

    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 ... is entered or scanned into the system accurately as monitored by system audit Accurate confirmation of attending PCP and Billing PCP, when appropriate. Assures… more
    Bassett Healthcare (05/23/25)
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  • Coder II

    Virginia Mason Franciscan Health (Tacoma, WA)
    …Franciscan Health, is currently seeking a full-time completely Remote Coder II for the Franciscan Coding department. Medical Specialty coding experience preferred ... function ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. The primary function of… more
    Virginia Mason Franciscan Health (05/24/25)
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  • Revenue Integrity Analyst II

    Intermountain Health (Boise, ID)
    …consistent and compliant application with charge/coding capture, charge editing, and audit and reimbursement practices. Researches and collaborates on regulation ... account within Intermountain's policies and procedures. Revenue Integrity Analyst II 1.Analyze data, develop reports, review trends, and recommend enhancements… more
    Intermountain Health (05/30/25)
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  • Billing Specialist II

    Community Health Systems (Birmingham, AL)
    …+ 1-3 years in collections, knowledge of third party billing and insurance reimbursement required and + 0-1 years Medicare experience preferred **Knowledge, ... **Job Summary** The Billing Specialist II is responsible for serving as primary contact...and important information to management. + Works all vendor/payer audit trails and files secondary claims. + Performs other… more
    Community Health Systems (05/21/25)
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  • SR Reimbursement Analyst

    Methodist Health System (Dallas, TX)
    …* Experience using HFS software preferred * Working knowledge of Hospital Medicare reimbursement areas of Wage Index, Medical Education, Organ Transplant, ... Shift :** **Job Description :** Your Job: The SR REIMBURSEMENT ( MEDICARE ) ANALYST will assist the Manager of...Age Specific Care and take a post test. Level's II and III have additional requirements for assessment and… more
    Methodist Health System (04/24/25)
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  • Provider Network Contracting Specialist II

    Centene Corporation (Sacramento, CA)
    …audits of provider agencies to evaluate provider contract adherence + Review, audit and price contract related pends to verify claims payment accuracy + ... relations or contracting experience in health care, managed care, Medicare or Medicaid services environment. **Licenses/Certifications:** Current state driver's… more
    Centene Corporation (05/23/25)
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  • Senior Corporate Compliance Auditor- REMOTE

    Fairview Health Services (St. Paul, MN)
    …Payment Systems (PPS) for inpatient and outpatient hospital services and the Medicare Physician Fee Schedule (MPFS) applicable to professional services. Must be ... including medical coding, billing, and documentation. + Applies comprehensive knowledge of Medicare and Medicaid guidelines under the Medicare Physician Fee… more
    Fairview Health Services (05/22/25)
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  • Coding Auditor Educator

    Highmark Health (Oklahoma City, OK)
    …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
    Highmark Health (05/09/25)
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  • Health Care Financial Analyst / Emergency…

    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
    The County of Los Angeles (04/28/25)
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  • Health Care Financial Analyst/Community Programs

    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 (05/29/25)
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  • Mental Health Program Manager I/Emergency…

    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 (05/13/25)
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