- Stanford Health Care (Palo Alto, CA)
- …accurate capture of all legitimate reimbursement opportunities. + Oversee Medicare and Medi-Cal audit processes, addressing inquiries and pursuing appeals ... is a Stanford Health Care job.** **A Brief Overview** The Director of Reimbursement is a key leadership role within the Controller's Office, responsible for… more
- Stanford Health Care (Palo Alto, CA)
- …works closely with all members of the Stanford Health Care Executive and Senior Leadership Teams. The Corporate Controller is one of the primary executives ... responsible for reporting to the Board of Directors, Audit , Compliance and Enterprise Risk Committee and Finance &...and approve the issuance of monthly financial package to senior management including CEO, CFO and COO. Provide expertise… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …forecast gross to net components including but not limited to Managed Care, and Medicare Part D, Medicaid as well as current and future Healthcare Reform related ... and Finance Responsible for ensuring that all rebate controls meet all audit and internal control (Sarbox) requirements Physical Requirements 0-10% overnight travel… more
- Saint Francis Health System (Tulsa, OK)
- …**to login and apply.** Full Time Job Summary: The Senior Internal Audit Analyst plays a critical role ... software, and data analytics platforms. Working knowledge of healthcare billing and reimbursement processes, particularly related to Medicare and Medicaid is… more
- LA Care Health Plan (Los Angeles, CA)
- Manager, Financial Compliance Audit , $10,000 SIGN ON BONUS Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 ... to achieve that purpose. Job Summary Manager, Financial Compliance Audit (Finance) has a $10,000 SIGN-ON BONUS. This role...(DMHC), Department of Health Care Services (DHCS), Centers for Medicare and Medicaid Services (CMS), and other federal and… more
- University of Southern California (Los Angeles, CA)
- This Senior Analyst of Government Reimbursement at Keck Medicine of USC position will support governmental reporting and reimbursement , focusing on tasks ... recommendations to the Manager for operational improvements based on audit findings, + Prepare Medicare Cost Report...the Manager as needed. + Monitor and interpret CMS, Medicare , and Medicaid reimbursement , including proposed and… more
- Molina Healthcare (Mesa, AZ)
- **JOB DESCRIPTION** **Job Summary** Provides senior level support for accurate and timely intake and interpretation of regulatory and/or functional requirements ... related to but not limited to coverage, reimbursement , and processing functions to support systems solutions development and maintenance for Medical Claim Audit .… more
- CareFirst (Baltimore, MD)
- …in DC Medicaid reimbursement . + Knowledge of Maryland Medicaid and Medicare reimbursement . + Excellent verbal and written communication skills. + Excellent ... fee schedules for plans that utilize the DC Medicaid reimbursement schedules and methodologies. This position may request to...may request to extend that knowledge across other Commercial, Medicare and Medicaid plans as needed. This may also… more
- Sutter Health (Sacramento, CA)
- …+ Understanding of hospital-based outpatient charging and coding + Knowledge of Medicare APC and OPPS reimbursement structures + In-depth knowledge of ... at communicating effectively with all levels of the organization, especially senior leadership and department heads. + Demonstrates skilled ability and comfort… more
- Omaha Children's Hospital (Omaha, NE)
- …DSH reporting, and other agency reporting over net patient revenue and reimbursement . Oversees general ledger accounts and ensures accuracy of financial statements ... members. **Essential Functions** Cost Reporting + Coordinates preparation of all Medicare and Medicaid cost reports. + Analyzes, interprets, and utilizes statistics… more
- University of Southern California (Los Angeles, CA)
- …(nursing or allied health), coding, provider billing, medical records, charge audit environment, CDM maintenance, Medicare /Medicaid reimbursement , managed ... in the billing system and CDM management tools. The Senior RI Specialist shall ensure that the Chargemaster (CDM)...with inpatient and outpatient billing requirements (UB-04) and CMS Medicare reimbursement methodology. + Req Knowledge of… more
- The Cigna Group (Bloomfield, CT)
- **Overview** The Senior Advisor Regulated Markets Audit Management role is responsible for coordinating the planning, execution and follow up for client and ... and other stakeholders to respond to State, Center for Medicare and Medicaid Services (CMS) and Client audit...401(k) with company match, company paid life insurance, tuition reimbursement , a minimum of 18 days of paid time… more
- University of Rochester (Brighton, NY)
- …on relevant reimbursement and billing issues and requirements (including CMS, Medicare Advantage, and New York State Medicaid). Stays abreast of Medicare ... the goals and expectations established for the Office of Counsel, the Senior Counsel identifies, analyzes and provides legal guidance and services on complex… more
- Centene Corporation (Jefferson City, MO)
- …audits related to Risk Adjustment processes. Ensures visibility by way of reporting out audit deliverables and risk related to each audit . + Serves as the ... of contact for external audits, and correspond with auditors related to audit acknowledgement, deliverables timelines and other inquiries. + Manages external … more
- Centene Corporation (Austin, TX)
- …candidate will have:_** + **_Knowledge of dual contract requirements (eg, Medicare -Medicaid plans)_** + **_Experience managing external audits and communicating with ... clear, actionable feedback_** + **_Skilled in developing and maintaining audit reporting, including tracking volume, identifying risks, and analyzing trends_**… more
- CareFirst (Baltimore, MD)
- …in DC Medicaid reimbursement . + Knowledge of Maryland Mediciad and Medicare reimbursement . + Excellent verbal and written communication skills. + Excellent ... activities. **ESSENTIAL FUNCTIONS:** + Analyze CareFirst's new and existing reimbursement arrangements/networks and assist management or senior level… more
- Catholic Health (Buffalo, NY)
- …budget impacts on Catholic Health (CH), reviewing opportunities and the monitoring of reimbursement . The Manager assists Senior Leadership with the review and ... years progressive experience in health care finance + Extensive understanding of Medicare and Medicaid regulations, cost reports, reimbursement and financial… more
- Beth Israel Lahey Health (Woburn, MA)
- …at the Beth Israel Deaconess Medical Center (BIDMC), the Revenue Integrity Senior Analyst contributes to Revenue Integrity and Coding oversight at the enterprise, ... compliance with applicable coding and billing guidelines, and optimization of reimbursement . * Support departments with analyzing services for coverage and … more
- New York State Civil Service (Oxford, NY)
- …and/or billing systems of a hospital or healthcare facility related to reimbursement rates, principles, and practices. Senior Health Care Fiscal Analyst: A ... NY HELP Yes Agency Health, Department of Title Senior Health Care Fiscal Analyst (NY HELPS) (Veteran...and solve problems.* Apply knowledge of third-party billing and reimbursement procedures, review and update procedures to assure third-party… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Risk Adjustment Business Operations Analyst assumes a pro-active approach in ensuring the accuracy and integrity of ... analyses and problem resolution to meet business operational requirements for Medicare Advantage(MA), Affordable Care Act (ACA) & Medicaid Lines of Business… more
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