Jobs near Mason: 5,198
RS
Relevance Score ranked on: APPEALS
Grievance/Appeals Analyst Lead
MASON, 4241 IRWIN SIMPSON RD
Monitors work flow and makes assignments to ensure the correct team resource is utilized to achieve accreditation and regulatory compliance metrics in a quality manner. May also be responsible to provide review and analysis of complex pre service and post service grievances and appeals requests from ...
Search Terms: Appeals, Analyst, Lead, Senior Analyst, Healthcare
87.2
0mi
Updated: September 17
Grievance/Appeals Representative I
Mason
?Reviews, analyzes and processes non-complex grievances and appeals in accordance with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear, understandable language. Utilizes guidelines and review tools to conduct ex...
Search Terms: Appeals, Representative, Retail, Healthcare, Medical
85.4
0mi
Updated: August 28
Audit & Reimbursement III- Medicare Cost Report Appeals
CINCINNATI, 3075 VANDERCAR WAY
Primary duties may include, but are not limited to:Analyzes and interprets data and makes recommendations for change based on judgment and experience. Able to work independently on assignments and under minimal guidance from the manager. Prepare detailed work papers and present findings in accordance...
Search Terms: Audit, Appeals, Project Management, Government, Administrative
77.1
19mi
Updated: August 28
Audit & Reimbursement II-Medicare Cost Report Appeals
CINCINNATI, 3075 VANDERCAR WAY
Primary duties may include, but are not limited to:Analyze and interprets data and makes recommendations for change based on their judgment and experience. Prepare detailed work papers and present findings in accordance with Government Auditing Standards (GAS) and CMS requirements. Gain experience wi...
Search Terms: Audit, Appeals, Project Management, Government, Administrative
77.1
19mi
Updated: August 28
Public Relations Director
Mason
Location: Elevance Health supports a hybrid workplace model (virtual and in-office) with Pulse. Point sites used for collaboration, community, and connection. This includes remote work and 1-2 days in office per week. The Public Relations Director is responsible for leading the communications and pub...
Search Terms: Public Relations, Director, Relations, Communications, Media
0
0mi
Updated: September 19
Investigator II - Carelon Payment Integrity
MASON, 4361 IRWIN SIMPSON RD
Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use of proprietary data and claims systems for review of facility, professional, and pharmacy claims. Responsible for identifying and developing enterprise-wide specific healthcare investigations that may ...
Search Terms: Investigator, Payment, Integrity, Healthcare, Business Services
0
0mi
Updated: September 19
Clinical Provider Auditor I
MASON, 4241 IRWIN SIMPSON RD
Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to accurately document determinations an...
Search Terms: Auditor, Clinical, Audit, Accounting, Healthcare
0
0mi
Updated: September 19
Clinical Provider Auditor II
MASON, 4241 IRWIN SIMPSON RD
Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to accurately document determinations an...
Search Terms: Auditor, Clinical, Audit, Behavioral Health, Accounting
0
0mi
Updated: September 19
Clinical Provider Auditor II
MASON, 4241 IRWIN SIMPSON RD
Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to accurately document determinations an...
Search Terms: Auditor, Clinical, Audit, Behavioral Health, Accounting
0
0mi
Updated: September 19
Clinical Provider Auditor II
MASON, 4241 IRWIN SIMPSON RD
Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to accurately document determinations an...
Search Terms: Auditor, Clinical, Audit, Behavioral Health, Accounting
0
0mi
Updated: September 19
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