- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Compliance Audit Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... required to achieve that purpose. Job Summary The Customer Solution Center (CSC) Audit Readiness Specialist II is responsible for the execution, oversight, and… more
- 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 (Los Angeles, CA)
- Customer Solution Center Quality Auditor II Job Category: Customer Service Department: Even MORE Quality Location: Los Angeles, CA, US, 90017 Position Type: Full ... Job Summary The Customer Solution Center Quality Auditor (QA) II is responsible for monitoring and actively influencing the...in the development of tools and procedures established to audit each vertical under the Customer Solution Center. In… more
- US Anesthesia Partners (Austin, TX)
- Overview The Accounts Receivable Representative II is responsible for collecting outstanding accounts receivable from third party payers; both government and ... on outstanding claims. + Process and follow up on appeals to insurance companies. + Refile s claims as...+ Maintain s basic proficiency with using spreadsheets. + Audit s adjustment requests and complete s when appropriate… more
- Medical Mutual of Ohio (OH)
- …outbound calls to members, providers, and pharmacies to initiate coverage determinations/ appeals , prescription refills, and switch members to lower cost therapeutic ... or updated CMS regulations, Coverage Gap Discount, Coverage Determinations and Appeals , Grievances, and Medicare marketing material requirements. . Assists in… more
- Hackensack Meridian Health (Hackensack, NJ)
- …by: I. Peer-to Peer (P2P) Concurrent appeals ii . Written Concurrent appeals iii. Recovery Audit Contractors & levels of appeal iv. Root cause analysis ... UMC. These include but are not limited to utilization review, hospital reimbursement , clinical compliance, case management, and transitions of care, as outlined in… more
- Hackensack Meridian Health (Hackensack, NJ)
- …**I. Peer-to Peer (P2P) Concurrent appeals ** ** ii . Written Concurrent appeals ** **iii. Recovery Audit Contractors & levels of appeal** **iv. Root cause ... These include but are not limited to utilization review,** **hospital reimbursement , clinical compliance, case management, and transitions of care, as** **outlined… more
- Sacramento County (Sacramento, CA)
- …apply, and explain utility rules procedures, policies, codes, and ordinances + Audit , reconstruct, and adjust financial records + Analyze and evaluate financial and ... paid experience performing the duties of Utility Billing Services Representative (Level II ) in Sacramento County. Or: Two years of full-time, paid experience in… more
- State of Colorado (Lakewood, CO)
- …Lakewood, CO Job Type Full Time Job Number RAA EDO 15422 Acct II 11/24 Department Department of Public Safety Division Executive Director's Office Opening Date ... and organizational development services. + Additional benefits offered include tuition reimbursement and reduced college tuition at CSU Global and DeVry University.… more
- State of Colorado (Canon City, CO)
- …holidays per year plus vacation and sick leave; + Wellness program, tuition reimbursement , training opportunities and more. Description of Job The Payroll Unit is ... four Data Management III positions and three Data Management II positions, overseeing all work related to the review,...with the Payroll Manager to ensure that access controls, audit , and reporting methods are available for all Payroll… more
- Stanford Health Care (Palo Alto, CA)
- …possess the creativity and motivation to drive change, realizing maximized reimbursement and minimized financial risk to Stanford Health Care. Successful oversight ... activities of insurance claim editing and billing, insurance follow-up, denial and appeals + Serve as a contact/resource to other departments and clinics for… more