- Baptist Memorial (Memphis, TN)
- …care experience and 3 years in Medicare billing environment. Previous audit experience, knowledge of InterQual and Medicare Billing practices. Minimum: Required ... education + Employee referral program Job Summary: Position: 12472 - Coordinator- RAC TPE Facility: BMHCC Corporate Office Department: HS Revenue Audit… more
- Henry Ford Health System (Troy, MI)
- …billing and coding records and the timely submission of documentation for Medicare Recovery Audit Contractors ( RAC ) and Third-Party Payer Audits. PRINCIPLE ... GENERAL SUMMARY: The Manager of Payor Audit is responsible for managing all third-party payer audit processes across the Henry Ford Health System which includes… more
- Hartford HealthCare (Farmington, CT)
- …are top priority and time sensitive; Centers for Medicare & Medicaid Services (CMS) Recovery Audit Contractor ( RAC ), Executive Health Resources (EHR), ... and payer medical record audits. Provides oversight for designated regulatory audit activity throughout HHC HIM. Oversees and monitor payment protocol through… more
- Penn Medicine (West Chester, PA)
- …medical and charge audits from commercial carriers and Medicare (MAC, CERT, RAC ) to ensure revenue management, revenue opportunities, and revenue protection. He/she ... Cobius system, inclusive, but not limited to, the out-patient RAC program and commercial carrier. This includes recording, reporting...action plans when corrective action is required based on audit findings. o Work as needed in any areas… more
- Truist (Charlotte, NC)
- …for operational governance in Consumer Indirect Lending Operations which includes DFS & RAC Product Refunds, DFS Funding and Support and SFC Servicing to optimize ... and adherence to CFPB Exam Request for DFS & RAC Product Refunds and Truist & RAC ...locations. 6. Responsible for creation and implementation of business recovery , business impact analysis and alternate site strategies for… more
- Mohawk Valley Health System (New Hartford, NY)
- …internal and external compliance audits for the Mohawk Valley Health System ("MVHS") audit and compliance function under the guidance and direction of the Chief ... + Develop and deliver compliance training based on identified audit findings. + Prepare detailed audit reports...and compile statistical analysis. + Serves as the primary RAC and appeals liaison for the hospital, including preparation… more
- Watco Companies LLC (Pittsburg, KS)
- …will not start until after January 1, 2025 A Revenue Accounting Clerk ( RAC ) is responsible for assisting in capturing revenue timely and accurately while being ... able to understand how the revenue is applied. The RAC will be able to answer basic revenue related...regarding the location(s) in which they are required to audit . Job Duties + Read and understand tariff and… more
- Catalent Pharma Solutions (St. Petersburg, FL)
- …manufacturing operations. + Experience preparing audit plans, audit reports, audit responses. + Auditor certification and/or RAC certification a plus. + ... Compliance Specialist will facilitate regulatory inspections, customer audits, internal audit program, and Certification programs. Provide oversight to assure timely… more
- Highmark Health (Columbus, OH)
- …entities in response to external coding audits conducted by the Medicare Administrative Contractor , the RAC , MIC, ZPIC, etc. Determine appeal action, prepare ... OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and… more
- 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 ... personnel with patient questions about itemized charges + Maintain reporting system of audit activities and identifies pattern and trending of results + Act as… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …prepares, and distributes meaningful reports using multiple databases. * Manage audit processes of medical record documentation and facilitates monitoring, tracking, ... and trending of audit results. Collect and organize data from multiple sources...documentation to minimize risk related to external auditors (ex: RAC , MIC, ZIP, etc.) regarding quality, profiling, coding and… more
- St. Luke's University Health Network (Allentown, PA)
- …team. 4. Oversees account changes pertaining to accepted and/or appealed audit recommendations and works with staff assisting with clerical and administrative ... tasks related the appeals/ audit function. 5. Identify and provide feedback, including identification...advisor in review of patient medical records identified by RAC /MIC/QIO and other insurers or outside auditors in retrospective… more
- University of North Carolina- Chapel Hill (Chapel Hill, NC)
- …at study team and compliance meetings * Preparing for monitoring and audit visits and addressing regulatory findings within required deadlines * Assisting with ... research studies Experience using an eRegulatory system (such as Florence) RAC , SoCRa, or ACRP certification preferred. Essential Skills: Demonstrated experience… more
- BeiGene (Emeryville, CA)
- …mitigation strategies throughout the CDx product lifecycle. + Lead efforts to audit and maintain compliance with internal and external regulations, including leading ... in Life Sciences, Regulatory Affairs, or a related field. Regulatory Affairs Certification ( RAC ) or similar credential is a plus. + 12+ years of regulatory… more
- Prime Healthcare (Ontario, CA)
- …over quarter improvement in CMS Value Based Purchasing Program.9 Serves as the Assistant RAC Coordinator in consultation with HIM Director and PHS Revenue Audit ... team.10. Establishes and implements a mechanism for ongoing communication with nursing/patient care staff and conducts senior rounding with staff and patients/families on a routine basis.11. Performs all other duties as assigned or required. #LI-CC1… more
- Mohawk Valley Health System (Utica, NY)
- …procedure codes, for accurate and timely billing of most appropriate payer + Audit charges and establish proper coding in collaboration with providers + Initiate and ... departments with diagnostic and procedural coding + Respond to Insurance, compliance and RAC denials + Review and assist in the maintenance of coding related… more
- Covenant Health Inc. (Knoxville, TN)
- …develop and instill a quality culture throughout the organization. + Reports audit results to departments, leadership, and in team meeting settings as appropriate. ... changes, etc. + Reviews charts for purposes of prebill, ADR, appeals, RAC . Qualifications Minimum Education: None specified; however, must be sufficient to meet… more
- American Water (Camden, NJ)
- …in the filing of base rate cases and alternative regulatory mechanisms (DSIC, RAC , trackers, etc). Ensure the financial support is complete, accurate and timely ... preparation and delivery of presentations including oral and written testimony * Audit , review and analysis of business and financial records * Execution and… more
- Northern Montana Hospital (Havre, MT)
- …Management experience with InterQual methodology and applications and programs along with RAC audit review experience. Prefer solid background in nursing along ... with 3 years of Case Management experience. BSN preferred. Health, dental, life, disability insurance and FLEX/HSA benefits available with 403-b option. Salary commensurate with up to 15 years of experience. The above information on this description has been… more
- American Water (Belleville, IL)
- …in the filing of base rate cases and alternative regulatory mechanisms (DSIC, RAC , trackers, etc.). Ensure the financial support is complete, accurate and timely ... analysis * Business report writing, preparation and delivery of presentations * Audit , review and analyze business and financial records * Execution and analysis… more