- State of Colorado (Denver, CO)
- …regarding all medical and clinical issues proposed by the Colorado Recovery Audit Contractor Program ( RAC ) and Department Staff overseeing this program. ... and approves clinical aspects of audit scenarios proposed by the RAC contractor . + Reviews and determines disposition of complex reviews at the appeal stage… more
- 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
- State of Minnesota (St. Paul, MN)
- …the Minnesota Restricted Recipient Program. + A thorough working knowledge of the state's Recovery Audit Contractor ( RAC ) and Universal Program Integrity ... Contractor (UPIC). + A thorough working knowledge of Medicaid provider audits and investigations methods and procedures. + Knowledge of regulatory aspects of state and federal policies to Minnesota Health Care Programs and the public benefit programs… more
- LifePoint Health (Martinsville, VA)
- …and improvements by service line, payer and provider. * * . Document and track all RAC and Payer audit requests including maintaining the RAC and Arthur ... and respond to denials and appeals requests. . Share RAC findings with key members of the organization. ....researching and resolving problems, issues and ability to articulate audit findings. Must be willing to learn new tasks… 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
- LSI Solutions (Victor, NY)
- …regulatory agencies, notified body, competent authorities, and/or authorized representative. + Provide audit support in the audit backroom. + Support internal ... on test reports. + Complete internal auditor training and participate on the internal audit team. + Contribute to product risk management (eg, FMEA and Risk Report… more
- UNC Health Care (Morrisville, NC)
- …standards such as CPT coding guidelines and CMS policies. Assists in preparing annual audit and work plan. Performs work outlined in work plan. Obtains and analyzes ... Assists in development of new policies and procedures and audit tools. Performs E/M and Procedural coding audits. Analyzes...and ensures correct coding and billing compliance. Assists with RAC audits and review of other outside requests as… more
- Hackensack Meridian Health (Eatontown, NJ)
- …incoming payer audit requests, including but not limited to CERT Audits, RAC requests, pre-payment audit requests and post-payment audit requests. ... and assigns staff to retrieve necessary documentation and draft audit response. Reviews all audit correspondence before...documentation and draft audit response. Reviews all audit correspondence before submission to payers for accuracy and… more
- Lockheed Martin (Grand Prairie, TX)
- …commitments\. *Participate in independent reviews including Readiness Acceptance Check \( RAC \), customer proposal / BOE reviews, customer negotiations, Defense ... Contract Audit Agency \(DCAA\) audits, Programs Reviews and Executive Leadership...such as Capability Maturity Model Integrated \(CMMI\), QMS System Audit \(AS9100, ISO9001\), AS9145 Desire and ability to implement… more
- UPMC (Cumberland, MD)
- …the ability to identify issues and present to management. + Interpret and key RAC Audit correspondence into the Audit + system. Understand payment posting ... and the relationship between co-pays, deductibles, co-insurance, allowances, and payments so that the account balance is accurate after payment is posted. Ability to navigate various payer websites or call payer directly when needed. + Key payment data from… more
- Hackensack Meridian Health (Hackensack, NJ)
- …+ Additional research will include Agency for Healthcare Research and Quality (AHRQ), Recovery Audit Program ( RAC ) Statement-of-Work (SOW), Office of ... performs all related internal, concurrent, prospective and retrospective coding audit activities across the Hackensack Meridian Health (HMH) network. Reviews… more
- Penn Medicine (Philadelphia, PA)
- …and develop the team and organization's point of view. Stay abreast of all audit activity including government audits (TPE, RAC , etc.) and other payer. Lend ... subject-matter expertise to develop robust coding and auditing education. Responsible to timely and effectively respond to Practice Revenue Cycle Department inquiries. Provide education and training to CFA staff regarding coding risk and opportunities to avoid… more
- St. John's Embrace Living (Rochester, NY)
- …payer audits. This includes but is not limited to Department of Health Survey, PRI Audit , OMIG Audits, Third Party/HMO Audits, RAC and MAC reviews + Assure all ... guidance regarding the delivery of liability notices is maintained. Update process and educate staff when process is changed + Assist medical records coding of ICD-10 codes + Submit PBJ data through QIES + Provide education to the interdisciplinary staff… more
- Truist (Atlanta, GA)
- …escalation and remediation plans, as well as Risk Committee reporting and audit support. 5. Develops and implements QA and QM routines, governance cadences ... Responsible for maintaining Wholesale's slate of proposals requiring funding ( RAC /TED, ESEC/SIC) or other enterprise approvals (Change Governance Program), including… more
- R1 RCM (Boise, ID)
- …to Revenue Cycle Management (RCM). + Often leading key projects to include Recovery Audit Contractors ( RAC ) Program, Charge Description Master (CDM), ... Texas Medicaid (TMHP), Transfer DRG Program, and Diagnosis Related Group (DRG) Validation. **Required** **Qualifications:** + Minimum 3 years' clinical or health care work experience and/or + Minimum 3 years' revenue cycle management in back-end working… 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
- Abbott (Santa Clara, CA)
- …and sustaining teams. + Participate in and support audits and responses to audit findings as appropriate, in root cause analysis, preventive or corrective actions, ... + Experience in Cardiovascular devices. + Certification is a plus (eg, RAC and PMP). Apply Now (https://www.jobs.abbott/us/en) * Participants who complete a short… more
- Bausch Health (San Francisco, CA)
- …test requirements, clarification, and follow-up of submissions under review. + Audit /Support Regulatory related submissions to relevant countries: US, Canada, China ... on US Canada and EU. + Possess a self-directed & problem-solving mindset. + RAC preferred but not required + Must possess the ability to work highly effectively… more
- Beth Israel Lahey Health (Charlestown, MA)
- …revenue cycle procedures andrelated controls. + Improve Revenue Cycle outcomes by overseeing RAC and regulatory audit tracking and review outcomes of audits to ... create targeted process improvement initiative and create internal controls. + Collaborate with clinical documentation improvement, coding and operational expertise to identify and target opportunities for measuring and reporting company and physician… more
- Mohawk Valley Health System (Utica, NY)
- …+ Provide peer-to-peer payor review in collaboration with attending physicians. + Support Recovery Audit Contractors ( RAC 's). + Assist with mitigating ... barriers to discharge and care progression. + Perform concurrent review of cases greater than 4 days or the assigned/estimated GMLOS + Partner with the care management team with the management of LOS, complex care needs and patient throughput efforts. Provide… more