• Audit & Reimbursement II

    Elevance Health (Columbus, OH)
    ** Audit & Reimbursement II Medicare Cost Report Appeals ** **Location** : This is a virtual position; US based **National Government Services** is a proud ... and Medicaid Services to transform federal health programs. The ** Audit and Reimbursement II ** will...report reopenings. + Under guided supervision, participate in completing appeals related work: + Position papers + Jurisdictional Reviews… more
    Elevance Health (09/17/24)
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  • Customer Solution Center Compliance Audit

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Compliance Audit Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, ... required to achieve that purpose. Job Summary The Customer Solution Center (CSC) Audit Readiness Specialist II is responsible for the execution, oversight, and… more
    LA Care Health Plan (08/06/24)
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  • Cultural and Linguistic Services Specialist…

    LA Care Health Plan (Los Angeles, CA)
    Cultural and Linguistic Services Specialist II Job Category: Clinical Department: Cultural & Linguistic Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... that purpose. Job Summary The Cultural and Linguistic Services (C&L) Specialist II is responsible for overseeing and ensuring the delegated subcontractors' (ie Plan… more
    LA Care Health Plan (08/03/24)
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  • Compliance Advisor II

    LA Care Health Plan (Los Angeles, CA)
    Compliance Advisor II Job Category: Administrative, HR, Business Professionals Department: Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... safety net required to achieve that purpose. Job Summary The Compliance Advisor II ensures LA Care business units are compliant with all Product Lines' contractual,… more
    LA Care Health Plan (09/09/24)
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  • Accounts Receivable Representative II

    US Anesthesia Partners (Maitland, FL)
    Overview The Accounts Receivable Representative II is responsible for collecting outstanding accounts receivable from third party payers; both government and ... claims + Process and follow up on more complex appeals to insurance companies + Refile claims as needed...daily + Maintain basic proficiency with using spreadsheets + Audit adjustment requests and complete when appropriate + Resolve… more
    US Anesthesia Partners (09/06/24)
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  • Revenue Integrity Analyst II

    Intermountain Health (Murray, UT)
    …consistent and compliant application with charge/coding capture, charge editing, and audit and reimbursement practices. Researches and collaborates on regulation ... updates to charging/coding/NCCI regulations and/or errors, and regarding audits and appeals , to facilitate corrective action planning for improved processes. +… more
    Intermountain Health (09/17/24)
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  • Physician Utilization Review Specialist Per Diem…

    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 ... These include but are not limited to utilization review, hospital reimbursement , clinical compliance, case management, and transitions of care, as outlined… more
    Hackensack Meridian Health (08/19/24)
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  • Analyst III - Legal Services

    State of Colorado (Colorado Springs, CO)
    …per year plus vacation and sick leave; + Wellness program, tuition reimbursement , training opportunities and more. Description of Job The Analyst III position ... and evaluating administrative regulations, federal ADA standards and ACA audit results in regards to ADA compliance and Colorado...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
    State of Colorado (09/05/24)
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