- 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
- Organon & Co. (Plymouth Meeting, PA)
- …Pharmacy, or government channel contracts. + Experience with pricing and reimbursement , Medicare , Medicaid, and government pricing implications. + Broad ... **Job Description** **The Position** The Contract Operations Sr . Specialist - US Market Access Contract Operations is responsible for overseeing the execution of… more
- Elevance Health (Independence, OH)
- …Medicaid Services to transform federal health programs. The ** Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) ... license and the ability to travel may be required. ** Audit & Reimbursement Senior ** **_Location:...Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare… more
- Covenant Health Inc. (Knoxville, TN)
- …liaison between CFOs, department managers, providers, and billing staff to maximize reimbursement within compliance guidelines for Medicare , Medicaid and other ... Summary: Performs complex level professional internal auditing work. Work involves compliance audit projects for Covenant Health entities as they relate to charging,… more
- Catholic Health Services (Rockville Centre, NY)
- …why Catholic Health was named Long Island's Top Workplace! Job Details The Senior Financial Analyst reports to the Reimbursement team within the Corporate ... complex data analysis. The ideal candidate possesses in-depth knowledge of Medicare /Medicaid reimbursement , managed care contracts, and healthcare finance. Key… more
- WellSense (MA)
- …between provider and internal Plan departments such as Provider Enrollment, Claims, Audit , Marketing, Customer Care and Care Management. **Our Investment in You:** . ... to pre-set site visit servicing standards** . **Acts as liaison for all reimbursement , credentialing, claims, EDI web site procedures and issues of key providers** .… more
- State of Minnesota (Vadnais Heights, MN)
- **Working Title: Revenue Integrity Manager** **Job Class: State Program Administrator, Manager Senior ** **Agency: Direct Care and Treatment** + **Job ID** : 91277 + ... Team and will be responsible for ensuring compliance with the Centers for Medicare and Medicaid Services (CMS), State Medicaid (MA), Private Insurance, and other… more
- Merck (Knoxville, TN)
- …areas; ensure integration with the Key Account Manager, Nurse Educator, Field Reimbursement Associate, Medicare Account Executive, and other key stakeholders to ... Digital Analytics, Healthcare Innovation, Healthcare Sales, Interpersonal Relationships, IS Audit , Lead Generation, Lead Generation Management, Market Access, Market… more
- University of Virginia (Charlottesville, VA)
- …and executive use. + Monitor regulatory changes provided by the Centers for Medicare and Medicaid Services (CMS) and the Virginia Department of Medical Assistance ... procedures, and applicable regulatory standards and requirements. + Completes chart audit reviews of clinical documentation to determine accuracy of charge capture.… more
- Saint Francis Health System (Tulsa, OK)
- …area. + Relocation assistance is available to support the transition. Job Summary: The Senior Internal Audit Analyst plays a critical role in evaluating and ... software, and data analytics platforms. Working knowledge of healthcare billing and reimbursement processes, particularly related to Medicare and Medicaid is… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …staff, Benefits Administration staff, Provider Audit , Network Administration and/or Medicare Advantage staff, and entry level Reimbursement Analyst by ... Medicare Advantage must have working knowledge of Medicare enrollment guidelines and reimbursement . **Licenses and...well as coordinating projects and time frames with less senior reimbursement staff. + Accountable for complying… 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 (Alhambra, CA)
- …(nursing or allied health), coding, provider billing, medical records, charge audit environment, CDM maintenance, Medicare /Medicaid reimbursement , managed ... 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
- 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 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
- Dana-Farber Cancer Institute (Brookline, MA)
- Reporting to the Director of Billing Compliance, the Senior Billing Compliance Reviewer will be responsible for the identification and performance of Billing ... Compliance inpatient and ambulatory activities. The Senior Reviewer will assist in the development and execution of the annual Billing Compliance work plan. They… 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)
- …for scalability, effectiveness, efficiency, and risk mitigation strategies + Perform audit planning, fieldwork, and wrap-up of engagements, including development and ... refinement of work programs + Assist in drafting audit reports, including summarizing key findings and recommendations and consolidation of metrics and graphing +… more
- New York State Civil Service (Albany, NY)
- …governmental agency, nonprofit organization, hospital or healthcare facility related to reimbursement rates, principles, and practices. Senior Health Care Fiscal ... HELP Yes Agency People With Developmental Disabilities, Office for Title Senior Health Care Fiscal Analyst-(Two Vacancies) Occupational Category Other Professional… 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
