- Parkview North Hospital (Fort Wayne, IN)
- …performing discretionary, special and required internal payor audits. Works within the payor audit team to meet operating goals, objectives and audit ... process. Utilizes critical thinking skills and analytical abilities to identify payor performance patterns and trends that lead to underpayment recovery… more
- UNC Health Care (Raleigh, NC)
- …Integrity Analyst is responsible for researching and resolving complex carrier/ payor claim edits, including but not limited to Correct Coding Initiative (CCI), ... Medically Unlikely Edits (MUEs) as well as complex payor denials/audits. Assists with appealing coding denials. Works with...Audits the accuracy of charges based on third party audit requests and document findings in internal audit… more
- RWJBarnabas Health (Oceanport, NJ)
- …support relating to contract interpretation, denial reviews, payment variances, and cost-based audit reviews. + Supports the loading of payor contracts into ... Senior Analyst (Remote) - Oceanport, NJReq #:0000150834 Category:Professional /...process. + Assists in varying aspects of managed care payor negotiations including proposals, rate validation, rebalancing, language review… more
- Rush University Medical Center (Chicago, IL)
- …more at our Rush benefits page . **Summary:** The Senior Revenue Integrity Analyst uses advanced knowledge of coding, CDM, charge capture, and auditing to ... timely capture of all chargeable procedures. The Senior Revenue Integrity Analyst also provides proactive high-level professional support in working advanced… more
- Sanford Health (Grand Forks, ND)
- …**Salary Range:** $27.50 - $44.00 **Job Summary** The Senior Reimbursement Analyst provides critical analytical and reimbursement related guidance and support to ... programs (340B) and CPT/HCPS code changes. Coordinates the impact analysis of payor proposed and final Medicare and Medicaid regulation changes. Coordinates the… more
- University of Rochester (Rochester, NY)
- …**Position Summary:** **This position oversees outpatient Medicare, Medicaid and third-party payor audits, and directs all responses to assure audits are responded ... and compiles responses to Medicare, Medicaid and third party payor audits within the guidelines provided by the governmental,...for the documentation and maintenance of all current outpatient audit workflows as it relates to these audits and… more
- Beth Israel Lahey Health (Charlestown, MA)
- …oversight of the Director or Manager of Revenue Integrity, the Revenue Integrity Analyst serves as a primary point of contact for Service Line Directors, Managers, ... and modality specific billing processes and/or workflows. The Revenue Integrity Analyst is responsible for educating providers, clinical colleagues and other members… more
- Hartford HealthCare (Farmington, CT)
- …entities across the system. Develops revenue models to estimate net revenues by payor for patients and produces and analyzes profit and loss information. Educates ... Develops net revenue models to estimate net revenue by payor for hospital and professional services patients. 7. Develops...be able to prioritize urgent high-level requests. 12. Develops audit reports and routines to ensure integrity of cost… more
- Hartford HealthCare (Farmington, CT)
- …entities across the system. Develops revenue models to estimate net revenues by payor for patients and produces and analyzes profit and loss information. Educates ... Develops net revenue models to estimate net revenue by payor for hospital and professional services patients. 7. Develops...develops analyses that lead to actionable insights. 11. Develops audit reports and routines to ensure integrity of cost… more
- Baptist Memorial (Memphis, TN)
- …is responsible for identifying payer accounts to determine compliance with payer contracts. The analyst will audit these accounts and follow up with payers on ... + Serve as subject matter experts and resources on interpretation of payor contract language to ensure appropriate reimbursement by insurance companies. + Identify,… more
- Vanderbilt University Medical Center (Nashville, TN)
- …**Organization:** Finance Reimb/Acct **Job Summary:** The primary purpose of the financial analyst is to support and perform analyses of financial matters related to ... Work is performed at a variety of levels including patient, program, payor , clinic, disease-site, patient care center, and others. Requires familiarity with clinical… more
- Corewell Health (Southfield, MI)
- …and processes in assigned areas of HIM Clinical Coding, and Coding Audit ; Inpatient, Outpatient, Emergency and Professional Coding Performs quality and compliance ... (ICD-10-CM/PCS, CPT/HCPCS) and understanding of government regulations, third party payor requirements and various reimbursement methodologies (MS-DRG, APR-DRG, APC,… more
- RWJBarnabas Health (West Orange, NJ)
- …Road, West Orange, NJ 07052 Position Summary: The Decision Support Senior Analyst provides financial and operational analysis, to enable management to make informed ... Service Line performance, Strategic Planning initiatives, Compliance, Managed Care Payor performance, Regulatory reporting, Purchasing Contract initiatives, and Revenue… more
- CommonSpirit Health (Englewood, CO)
- …CHI's balance sheet) and is a focus of the financial audit . **Key Responsibilities** + Reimbursement Calculation/Contract build/modeling - (Business critical ... maintenance) - Input and maintenance of Payor contracts to calculate net expected reimbursement and applies...in system dictionaries and tables, based on collaboration with Payor Strategy and RRC management. + Interprets managed care… more
- Highmark Health (Columbus, OH)
- …and reporting of revenue and compliance with government and third party payor requirements.Assesses the accuracy of all charging vehicles, including clinical systems ... with Compliance, Budget Office, Patient Accounts, Health Information Services, Internal Audit and other Revenue and Finance departments on revenue management… more
- UPMC (Pittsburgh, PA)
- …overall results (ie, effectiveness assessments) of the regular, special and CERT+ audit programs. + Develop and manage relationships with colleagues in a ... other departments within the medical center. + Develop computer based audit spreadsheet that accurately depict all coding/documentation discrepancies, identifies the… more