- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist II is...of improvement to assist the department in increasing positive audit outcomes and improved Customer Service to LA Care's… 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
- 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
- SSM Health (MO)
- …Summary:** Enhances overall financial performance by reviewing all assigned government audit denials and determining appropriate follow-up actions. Appeals ... Type:** Regular **Job Highlights:** Exciting opportunity for an Corporate Responsibility Auditor Senior role SSM Health! Preferred RN background is a plus. **Job… more
- Ascension Health (Austin, TX)
- …disability Employee assistance programs (EAP) Parental leave & adoption assistance Tuition reimbursement Ways to give back to your community _Benefit options and ... Responsible for reviewing, investigating and resolving health-care claim payment appeals and communicating resolution/determination in accordance with the standards… more
- Beth Israel Lahey Health (Burlington, MA)
- …a difference in people's lives.** Under the managerial oversight of the Director, Senior Manager, or Manager of Revenue Cycle, the Revenue Cycle Analyst serves as ... is responsible for improving revenue cycle workflow, efficiency, accuracy, reimbursement , and overall revenue control through operational and system enhancements… 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
- Ascension Health (Wichita, KS)
- …disability Employee assistance programs (EAP) Parental leave & adoption assistance Tuition reimbursement Ways to give back to your community _Benefit options and ... at the time of the offer._ **Responsibilities** Coordinate payer denials and appeals , respond to insurance company requests for medical records, and perform medical… more
- Stanford University (Stanford, CA)
- …empower you with: + Freedom to grow. We offer career development programs, tuition reimbursement , the ability to audit a course, join a TedTalk, film screening, ... their lives. Reporting to the Global HR Director and in partnership with the Senior Director of Benefits, the Global Benefit Analyst will be responsible for global… 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
- WesleyLife (Urbandale, IA)
- …feedback and deliver performance reviews with input from Nurse Case Managers. + Audit charts and ensure plans of care are completed. + Oversee chart reviews ... + Complete additional development request (ADR) reviews and insurance denial appeals . + Perform admissions, client visits, and supervisory visits. **What We… more
- Iowa Department of Administrative Services (State Of Iowa, IA)
- …regarding relatedrelevant program areas (tax credits and pass-through entities), compliance programs, audit standards, and issues leading to appeals . + Oversee ... Section of the Research and Policy Division. The Policy Director will work with senior management within the Department to set goals and develop plans for the… more
- Beth Israel Lahey Health (Burlington, MA)
- …situational thresholds as defined by department leadership will be sent to the Senior Manager for final review and approval. 4. Responsible for the resolution of ... meetings and serves on committees as requested. 18. Achieves exemplary audit results and consistently exceeds productivity standards. 19. Provides and promotes… more
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