- Molina Healthcare (Grand Rapids, MI)
- 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. This role includes coordination with… more
- Guthrie (Sayre, PA)
- … Manager is responsible for the oversight and management of all payer denials, appeals , and audit processes within the health system. This role ensures timely ... or insurance with responsibility and management of billing and reimbursement . Essential Functions Denials & Appeals Management...reports to track denial rates, appeal success rates, and audit recoveries + Provide monthly summaries to senior… more
- University of Southern California (Alhambra, CA)
- …determining the need for appeal. Performs all 1st and 2nd level coding-related denial appeals . All tasks & duties to be perform in compliance with federal & state ... or delay payment of a particular claim or group of claims. Prepares appeals and rebuttals letters/packages in responses to payer's reason for coding-related 'claims… more
- Stanford Health Care (Palo Alto, CA)
- …of all legitimate reimbursement opportunities. + Oversee Medicare and Medi-Cal audit processes, addressing inquiries and pursuing appeals or litigation when ... Health Care job.** **A Brief Overview** The Director of Reimbursement is a key leadership role within the Controller's...shaping the financial integrity of the organization. As a senior member of the team, this individual actively contributes… more
- Molina Healthcare (UT)
- **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. This role includes… more
- Bristol Myers Squibb (Tampa, FL)
- …ad-hoc inquiries, as well as ensuring the timely completion of audit requests and providing necessary information for compliance, audits, contract management, ... designed; supports the implementation and adherence to SOX controls and compliance, audit activities as needed, ensures compliance for all plan documents and… 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 ... Exempt: Yes Work Schedule: Days Hours: 8a-4p Summary: The Manager Government Reimbursement reports to the Director Government Reimbursement and Managed Care.… 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
- Houston Methodist (Houston, TX)
- …Medicare cost report for each HM hospital and assists in cost report amendments, audit , appeals and reopening process. + Independently prepares federal and state ... At Houston Methodist, the Senior (Sr.) Accountng and Reporting Analyst position is...compiling information to effectively report costs and seek maximum reimbursement from various government programs. The Sr. Accounting and… more
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