- UNC Health Care (Hendersonville, NC)
- …the health and well-being of the unique communities we serve. Summary: The Recovery Audit Contractor (RAC) Coordinator (RN) is responsible and accountable for ... all Care Management Denial and Recovery Audit Contractor (RAC) requests and follow-ups, including tracking of approvals and denials as well as coordinating and… more
- Kohl's (Menomonee Falls, WI)
- …documentation and recommend process improvements to prevent recurring issues + Complete assigned recovery audit projects to ensure negotiated terms and funds are ... Access or other query tools for data analysis + 3-5 years of Recovery Audit experience or Data Analysis + Excellent analytical skills and technical capabilities… more
- Henry Ford Health System (Troy, MI)
- …and coding records and the timely submission of documentation for Medicare Recovery Audit Contractors (RAC) and Third-Party Payer Audits. PRINCIPLE DUTIES ... 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
- AutoZone, Inc. (Memphis, TN)
- The Associate Audit Recovery Auditor utilizes analytical and forensic email review skills to audit Merchandising negotiations to recover missed funding for ... will also acquire a knowledge base of Merchandising concepts and programs and recovery industry knowledge to ensure all recoveries for all concepts are captured… more
- PRGX (Grand Rapids, MI)
- …and expand impact across our clients' organizations for healthier whole businesses. PRGX pioneered Recovery Audit nearly 50 years ago and is now the global ... value. With end-to-end technology and deep vertical expertise that underpins our recovery , preventive, and analytics solutions, we provide the actionable insights to… more
- Hartford HealthCare (Farmington, CT)
- …top priority and time sensitive; Centers for Medicare & Medicaid Services (CMS) Recovery Audit Contractor (RAC), Executive Health Resources (EHR), appeals and ... and payer medical record audits. Provides oversight for designated regulatory audit activity throughout HHC HIM. Oversees and monitor payment protocol through… more
- PRGX (Atlanta, GA)
- …and expand impact across our clients' organizations for healthier whole businesses. PRGX pioneered Recovery Audit nearly 50 years ago and is now the global ... value. With end-to-end technology and deep vertical expertise that underpins our recovery , preventive, and analytics solutions, we provide the actionable insights to… more
- TEKsystems (Indianapolis, IN)
- …- claim submission - third party follow up - cash posting - denial appeal and recovery - audit defense and recovery - patient collections Additional Skills & ... Qualifications: MUST HAVE: - 1+ year of medical office or healthcare experience where they handle health insurance (do they understand copays and deductibles and medical terminology, etc.) - Some type of experience in claims or collections would be nice -… more
- PRGX (Atlanta, GA)
- …and expand impact across our clients' organizations for healthier whole businesses. PRGX pioneered Recovery Audit nearly 50 years ago and is now the global ... value. With end-to-end technology and deep vertical expertise that underpins our recovery , preventive, and analytics solutions, we provide the actionable insights to… more
- PRGX (Atlanta, GA)
- …and expand impact across our clients' organizations for healthier whole businesses. PRGX pioneered Recovery Audit nearly 50 years ago and is now the global ... value. With end-to-end technology and deep vertical expertise that underpins our recovery , preventive, and analytics solutions, we provide the actionable insights to… more
- PRGX (Atlanta, GA)
- …and expand impact across our clients' organizations for healthier whole businesses. PRGX pioneered Recovery Audit nearly 50 years ago and is now the global ... value. With end-to-end technology and deep vertical expertise that underpins our recovery , preventive, and analytics solutions, we provide the actionable insights to… more
- Eastern Connecticut Health Network (Vernon, CT)
- …audits that include but is not limited to Additional Documentation Requests (ADR), Recovery Audit Contractors (RAC), and Third-Party Liability (TPL). + Responds ... Administrator to coordinate department activities. Supports the department's efforts to audit , track and trend patient outcomes, analyzes data, develops and… more
- State of Minnesota (St. Paul, MN)
- …Program._ + _Knowledge of the Unified Program Integrity Contractor (UPIC) and Recovery Audit Contractor (RAC) programs within the State Medicaid Agency._ ... agencies. + Review, direct, correct, prepare written reports summarizing investigative/ audit activities conducted by others. **Preferred Qualifications** + _Knowledge… more
- Granville Medical Center (Oxford, NC)
- …indicators. * Obtains documentation relevant to denials avoidance related to the Recovery Audit program, the Comprehensive Error Rate Testing (CERT) program, ... and other audit programs, recognizing and disseminating to physicians the importance of clinical documentation for both the physician and the hospital. * Reviews… more
- Granville Health System (Oxford, NC)
- …Admission indicators. #Obtains documentation relevant to denials avoidance related to the Recovery Audit program, the Comprehensive Error Rate Testing (CERT) ... program, and other audit programs, recognizing and disseminating to physicians the importance of clinical documentation for both the physician and the hospital.#… 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 transition… more
- Hackensack Meridian Health (Hackensack, NJ)
- …denials by: I. Peer-to Peer (P2P) Concurrent appeals ii. Written Concurrent appeals iii. Recovery Audit Contractors & levels of appeal iv. Root cause analysis & ... trends v. Participation in Managed Care Contracting & distribution of contract terms where appropriate + Utilization Review Process a. Subject Matter Expert in the use & application of Utilization Management Criteria ( ie MCG, Xsolis) b. Supports &… more
- Hackensack Meridian Health (Hackensack, NJ)
- …by:** **I. Peer-to Peer (P2P) Concurrent appeals** **ii. Written Concurrent appeals** **iii. Recovery Audit Contractors & levels of appeal** **iv. Root cause ... analysis & trends** **v. Participation in Managed Care Contracting & distribution of contract terms where appropriate** **7. Utilization Review Process** **a. Subject Matter Expert in the use & application of Utilization Management Criteria ( ie MCG,**… more
- NCR Atleos (Atlanta, GA)
- …vision for future directions to meet changing business needs. + Oversee Disaster Recovery (DR) activities, audit activities, and ensure the successful ... recovery of systems and data. + Manage vendor relationships, including performance monitoring and issue resolution. + Hire, train, and develop team members to ensure the necessary skills and expertise are in place (no direct report initially). + Monitor… more
- Robert Half Management Resources (Yuba City, CA)
- Description We are in need of a VP of Asset Recovery to join our team in Yuba City, California. As the VP of Asset Recovery , your primary role will be the ... supervision and operation of the Asset Recovery Department, along with the development and implementation of...and delegate tasks to department personnel * Monitor and audit all collection activities within the department * Ensure… more
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