• Recovery Audit Contractor (RAC)…

    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
    UNC Health Care (11/28/24)
    - Save Job - Related Jobs - Block Source
  • Senior Recovery Analyst - Remote Eligible

    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
    Kohl's (01/02/25)
    - Save Job - Related Jobs - Block Source
  • Manager- Payor Audit /Full Time/Hybrid

    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
    Henry Ford Health System (11/20/24)
    - Save Job - Related Jobs - Block Source
  • Associate Recovery Auditor

    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
    AutoZone, Inc. (12/24/24)
    - Save Job - Related Jobs - Block Source
  • Analyst I

    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
    PRGX (11/26/24)
    - Save Job - Related Jobs - Block Source
  • Mgr Release of Information / HIM ROI

    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
    Hartford HealthCare (11/25/24)
    - Save Job - Related Jobs - Block Source
  • Accounts Payable Specialist

    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 (11/15/24)
    - Save Job - Related Jobs - Block Source
  • Medical Collections/Billing CSR

    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
    TEKsystems (01/03/25)
    - Save Job - Related Jobs - Block Source
  • Sales Enablement Specialist

    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 (12/13/24)
    - Save Job - Related Jobs - Block Source
  • Senior Tech Ops Engineer

    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 (11/19/24)
    - Save Job - Related Jobs - Block Source
  • Sr. Data Scientist Generative AI

    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 (10/08/24)
    - Save Job - Related Jobs - Block Source
  • Quality Manager

    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
    Eastern Connecticut Health Network (01/02/25)
    - Save Job - Related Jobs - Block Source
  • Federal Audits and Investigations Supervisor…

    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
    State of Minnesota (12/28/24)
    - Save Job - Related Jobs - Block Source
  • CDI Specialist

    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 Medical Center (12/20/24)
    - Save Job - Related Jobs - Block Source
  • CDI Specialist

    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
    Granville Health System (12/05/24)
    - Save Job - Related Jobs - Block Source
  • Physician Advisor

    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
    Mohawk Valley Health System (12/18/24)
    - Save Job - Related Jobs - Block Source
  • Physician Utilization Review Specialist Per Diem…

    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 (11/18/24)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Physician Full Time

    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
    Hackensack Meridian Health (11/02/24)
    - Save Job - Related Jobs - Block Source
  • Senior Solution Owner

    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
    NCR Atleos (11/27/24)
    - Save Job - Related Jobs - Block Source
  • VP of Asset Recovery

    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
    Robert Half Management Resources (12/13/24)
    - Save Job - Related Jobs - Block Source