- Centene Corporation (Austin, TX)
- …Purpose:** Leads teams and individuals in the performance of internal audit activities, provides independent objective assurance and consulting services, builds ... more
- LifePoint Health (Brentwood, TN)
- …reports and other regulatory reporting requirements for 7 hospitals. Works with the Medicare Audit Contractors (MACs)and Medicaid State Agencies during the ... more
- Elevance Health (Denver, CO)
- …Medicare and Medicaid Services to transform federal health programs._ The ** Audit and Reimbursement Senior** will support our Medicare Administrative Contract ... more
- Nuvance Health (Danbury, CT)
- …Intermediary, the Provider Reimbursement Review Board, NYS, OHS and the OIG. 5.Reviews Medicare audit reports to seek opportunities for adjustments or appeals. ... more
- Elevance Health (Smithfield, RI)
- …Requirements:** + Requires a BA/BS degree and a minimum of 5 years of audit /reimbursement or related Medicare experience; or any combination of education and ... more
- Walmart (Orlando, FL)
- …process Medicare orders to ensure compliance; and interpreting and documenting Medicare audit documents. + Ensures fulfillment of pharmacy prescriptions in a ... more
- Humana (Frankfort, KY)
- …DSNP Medicare Operations. Serve as the subject matter expert on DSNP Medicare Operations. + Develop audit methodology and perform auditing and monitoring ... more
- Healthfirst (MS)
- …to ensure accuracy + Manages any new PDE and claims processes related to Medicare policy updates, audit findings, and benefits changes + Participates in and ... more
- Charter Care Health Partners (Providence, RI)
- …year; submit executive summary and action plan to the GME Office + Prepare Medicare Audit documents, per the GME Office's instructions + Manage fellow financial ... more
- HCA Healthcare (Nashville, TN)
- …criteria is met in compliance with departmental policies and procedures + Review Medicare Recovery Audit Contractor (RAC) recoupment requests and process or ... more
- Medical Mutual of Ohio (OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Medical Mutual' s ... more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- The Medicare Billing and Follow-up Representative are responsible for the compliant, accurate and timely billing and follow-up of all hospital Medicare and ... more
- CommuniCare Health Services Corporate (Indianapolis, IN)
- Medicare Biller The CommuniCare Family of Companies currently owns/manages over 130 World-Class Nursing and Rehabilitation Centers, Specialty Care Centers, and ... more
- Intermountain Health (Murray, UT)
- …Medicare COB file process + Medicare compliance + Experience with annual Medicare + Experience with program audit universes + FIR transactions + An ... more
- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and ... more
- CVS Health (Harrisburg, PA)
- …Summary** As a Manager, Business Analytics you will be part of the Medicare Grievance Team, responsible for managing business and system initiatives that focus on ... more
- Elevance Health (Costa Mesa, CA)
- ** Medicare Quality Management Health Planning Director Sr.** **Location:** This position will work in a hybrid model (remote and office). The ideal candidate will ... more
- Fallon Health (Worcester, MA)
- …to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- ... more
- Corewell Health (Grand Rapids, MI)
- …support operational compliance with regulatory and accreditation requirements and to ensure Medicare , Medicaid and NCQA audit readiness for the Medical ... more
- Molina Healthcare (FL)
- …population, and triage activities. + Ensures completion of staff quality audit reviews. Evaluates services provided and outcomes achieved and recommends ... more