• Clinical Denials Coding Review Specialist

    HCA Healthcare (Nashville, TN)
    …criteria is met in compliance with departmental policies and procedures + Review Medicare Recovery Audit Contractor (RAC) recoupment requests and process ... more
    HCA Healthcare (02/20/25)
    - Save Job - Related Jobs - Block Source
  • Pro-Fee Compliance Analyst (40 hours/week)

    Penn Medicine (Lititz, PA)
    …external audits from the Center of Medicare and Medicaid Services CMS , Recovery Audit Contractors RAC and Medicare Administrative Contractor MAC , ... more
    Penn Medicine (03/04/25)
    - Save Job - Related Jobs - Block Source
  • Sr Provider Audit Analyst-2

    Point32Health (MA)
    …to our members, partners, colleagues and communities. **Job Summary** The Sr Provider Audit Analyst is responsible for review of claims for accuracy of coding, ... more
    Point32Health (01/22/25)
    - Save Job - Related Jobs - Block Source
  • Investigator, SIU-Pharmacy Audit

    Molina Healthcare (AZ)
    …for supporting the prevention, detection, investigation, reporting, and when appropriate, recovery of money related to health care fraud, waste, and abuse. ... more
    Molina Healthcare (03/04/25)
    - Save Job - Related Jobs - Block Source
  • CDM Analyst RI Auditor

    Chesapeake Regional Healthcare (Chesapeake, VA)
    …reviews documentation on all Observation accounts for carve-out observation hours, extended recovery , the charge coding of ED Visits and Injection and Infusion ... more
    Chesapeake Regional Healthcare (01/25/25)
    - Save Job - Related Jobs - Block Source
  • Senior Director, Care Mgmt

    Sutter Health (Emeryville, CA)
    …* Establish preemptive and proactive model to prepare an entities for successful recovery audit contractor (RAC) responses, including unscheduled audit ... more
    Sutter Health (02/06/25)
    - Save Job - Related Jobs - Block Source
  • Financial Specialist Assistant

    NHS Management, LLC (Athens, AL)
    …offers you the unique opportunity to walk alongside patients on their road to recovery from many different conditions. As you care for and help patients achieve ... more
    NHS Management, LLC (03/12/25)
    - Save Job - Related Jobs - Block Source
  • Nurse Auditor/Rev Intgty Spec

    Chesapeake Regional Healthcare (Chesapeake, VA)
    …personnel with patient questions about itemized charges . Maintain reporting system of audit activities and identifies pattern and trending of results . Act as ... more
    Chesapeake Regional Healthcare (01/04/25)
    - Save Job - Related Jobs - Block Source
  • Ambulatory Office Assistant II

    Bassett Healthcare (Stamford, NY)
    …sent via mail, phone, or MyBassett to meet patient satisfactions. Takes a lead in service recovery and acts as a service liaison in the moment. Acts as a trainer for ... more
    Bassett Healthcare (03/14/25)
    - Save Job - Related Jobs - Block Source
  • RN Denial Management Specialist

    Banner Health (AZ)
    …SUMMARY This position is responsible for providing support to the organization's Recovery Audit Contractor (RAC) program by reviewing clinical information and ... more
    Banner Health (03/13/25)
    - Save Job - Related Jobs - Block Source
  • Investigator, SIU RN

    Molina Healthcare (Columbus, OH)
    …for supporting the prevention, detection, investigation, reporting, and when appropriate, recovery of money related to health care fraud, waste, and abuse. ... more
    Molina Healthcare (01/21/25)
    - Save Job - Related Jobs - Block Source
  • Revenue Integrity Specialist

    Chesapeake Regional Healthcare (Chesapeake, VA)
    …documentation on all Observation accounts for carve-out observation hours, extended recovery , and event management, spot checking accounts with random audits. ... more
    Chesapeake Regional Healthcare (01/24/25)
    - Save Job - Related Jobs - Block Source
  • Physician Advisor

    Catholic Health Initiatives (Omaha, NE)
    …in a data-driven approach + Facilitate pre-payment reviews and/or participating in recovery audit contractor reviews + Assist Hospital Administration in billing ... more
    Catholic Health Initiatives (02/20/25)
    - Save Job - Related Jobs - Block Source
  • Physician Advisor - Utilization Management

    Ochsner Health (New Orleans, LA)
    …in a data-driven approach + Facilitate pre-payment reviews and/or participating in recovery audit contractor reviews + Assist Hospital Administration in appeals ... more
    Ochsner Health (01/29/25)
    - Save Job - Related Jobs - Block Source
  • AVP, Payment Integrity (Data Analytics)

    Molina Healthcare (Columbus, OH)
    …+ Claims Adjudication accuracy including configuration in QNXT (ie Claims Production, Audit , Production Vendor Oversight) for all lines of business. Claims Shared ... more
    Molina Healthcare (02/22/25)
    - Save Job - Related Jobs - Block Source
  • Mental Health Program Manager I/Emergency…

    The County of Los Angeles (Los Angeles, CA)
    …and procedures concerning administration, ensuring compliance with Federal and State Medicare and Medicaid regulations for reimbursement claiming and maximum ... more
    The County of Los Angeles (03/10/25)
    - Save Job - Related Jobs - Block Source
  • Health Care Financial Analyst / Emergency…

    The County of Los Angeles (Los Angeles, CA)
    …rules and regulations and result in maximum revenue collection. + Prepares Medicare and Medi-Cal cost reports and State mandated disclosure reports. + Analyzes ... more
    The County of Los Angeles (03/13/25)
    - Save Job - Related Jobs - Block Source
  • Health Care Financial Analyst / Emergency…

    The County of Los Angeles (Los Angeles, CA)
    …rules and regulations and result in maximum revenue collection. Prepares Medicare and Medi-Cal cost reports and State mandated disclosure reports. Analyzes ... more
    The County of Los Angeles (03/10/25)
    - Save Job - Related Jobs - Block Source
  • Director of Accounting and Compliance

    Monte Nido (Miami, FL)
    …Our mission is to provide compassionate, evidence-based care that supports long-term recovery . We are seeking a Director of Accounting and Compliance to join ... more
    Monte Nido (03/09/25)
    - Save Job - Related Jobs - Block Source
  • Manager, Compliance & Revenue Integrity

    Cedars-Sinai (CA)
    …RACs, government billed claims and inpatient stay reviews, and commercial payer audit and recovery programs. Communicates trends and presents executive updates ... more
    Cedars-Sinai (12/25/24)
    - Save Job - Related Jobs - Block Source