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Confidential
A company is looking for an Appeals Specialist. Key Responsibilities: Ensure correct categorization of complaints Obtain additional documentation required for case review Review cases and render decisions for non-clinical complaints Required...
Confidential
A company is looking for a Medical Appeals Coder for a remote position in the healthcare industry. Key Responsibilities: Research denials and provide correction suggestions to other departments for resubmission Complete contractual adjustments...
Confidential
A company is looking for a Senior Appeals Analyst for a fully remote position. Key Responsibilities: Receive, review, and address appeals from providers, ensuring compliance with regulations Analyze provider counteroffers on claims and engage...
Confidential
A company is looking for a Grievance and Appeals Coordinator. Key Responsibilities: Administrate Standard and Expedited Appeals Processes in compliance with regulatory requirements Investigate and resolve member grievances and appeals...
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A company is looking for a Coding Auditor. Key Responsibilities: Perform coding reviews of medical records and/or other documentation to determine correct coding Utilize proprietary auditing systems to document audit determinations and...
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A company is looking for an Appeals and Grievances Analyst. Key Responsibilities: Process Appeals and Grievances by evaluating initial decisions against CMS guidelines and enrolee benefits Prepare detailed summary statements and research to...
Confidential
A company is looking for a Senior Internal Audit Risk Review and Methodology Director. Key Responsibilities: Provide direction and guidance to the internal audit department for auditing key risks across the enterprise and evolve the audit...
Confidential
A company is looking for a Quality Reviewer. Key Responsibilities: Review data entered by system users, perform data quality approvals, enforce and audit data for compliance with system and procedure requirements Perform data queries/reports to...
Confidential
A company is looking for an Audit Specialist for a fully remote position. Key Responsibilities: Maintain and review documentation for insurance coverage and reimbursement Retrieve and analyze documentation for audits conducted by Medicare,...
Confidential
A company is looking for an Audit Senior to work remotely and perform financial statement audits, reviews, and compilations for various client industries. Key Responsibilities: Work on financial statement audits within an audit engagement team...
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A company is looking for a Senior Appeals and Negotiation Analyst. Key Responsibilities: Receive, review, and address appeals from providers in compliance with industry guidelines and regulations Analyze provider counteroffers on claims to...
Confidential
A company is looking for a Supervisor for Utilization Management Review. Key Responsibilities: Provide daily oversight of UM Nurses, UM Technicians, and staff members within Utilization Management Assist with the daily operations of licensed...
Confidential
A company is looking for a CPA Audit Manager. Key Responsibilities: Assist with wrap-up and review after audit fieldwork Review draft financial statements and related audit documents Report audit findings to stakeholders and train and develop...
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A company is looking for a Remote Audit and Assurance Supervisor. Key Responsibilities: Plan and conduct audits of client financial statements Assist with the development of appropriate audit programs Prepare detailed reports of audit findings...
Confidential
A company is looking for a Manager, Internal Audit. Key Responsibilities: Plan and deliver internal audits, process reviews, and SOX efforts Develop reports and present results to supervisors and stakeholders Build relationships, establish...
Confidential
A company is looking for an Inpatient Auditing Specialist. Key Responsibilities: Perform Diagnostic Related Group (DRG) validation and quality audits on Inpatient Collaborate with team members to ensure accurate coding and support in denial...
Confidential
A company is looking for an Audit Support Analyst. Key Responsibilities: Provide strategic collaboration of financial, reporting, project, and operational support for assigned areas of the business unit and client Configure custom claim reviews...
Confidential
A company is seeking a Senior Internal Audit Manager for a remote position nationwide. Key Responsibilities: Lead the risk assessment and planning process for internal audit across the organization Evaluate the business for potential areas of...
Confidential
An organization is seeking an Internal Audit IT Senior Auditor for a remote position in the United States. Key Responsibilities: Support the preparation of the annual risk assessment Execute the global SOX program, including IT risk assessment,...
Confidential
A company is looking for a Bilingual Bulgarian Senior Document Review Attorney for remote, full-time work. Key Responsibilities: Project-based E-Discovery/Document Review Conduct investigation reviews (FCPA/Pharma) Utilize Brainspace for...
Confidential
A company is looking for a Senior IT Internal Audit Manager. Key Responsibilities: Ensure timely review and updates to IT process documentation and controls for new and existing systems relevant to financial reporting Coordinate with...
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A company is looking for a Remote Benefit Plan Audit and Assurance Senior. Key Responsibilities: Complete compilation, review, and audit engagements, with a primary focus on employee benefit plan audits Conduct audits of client plan financials...
Confidential
A company is looking for a Senior Document Review Attorney fluent in English and Russian for a remote full-time position. Key Responsibilities: Project-based E-Discovery/Document Review Conducting investigation reviews (FCPA/Pharma) Utilizing...
Confidential
A company is looking for an Audit Manager for Employee Benefit Plans. Key Responsibilities: Audit defined contribution pension plans, defined benefit pension plans, and health and welfare plans Assist with wrap-up and review after audit...
Confidential
A company is looking for a Benefits Analyst. Key Responsibilities: Calculate benefits for employees on parental leave and input leave information in Workday Process requests and deductions for the Flex Pass program Review and process requests...
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A company is looking for a Revenue Cycle Specialist to perform all aspects of the full revenue cycle in Revenue Cycle Management with knowledge of government payers Medicare and Medicaid. Key Responsibilities: Manage patient accounts for...
Confidential
A company is looking for an Auditor (multi-specialty). Key Responsibilities: Perform comprehensive audits and reviews of coding, documentation, billing, and compliance Create accurate reports summarizing audit findings and recommendations...
Confidential
A company is looking for a Customer Operations Coordinator. Key Responsibilities: Review and interpret vendor agreements, pricing documentation, and contract documentation Research and resolve pricing inquiries and audits Ensure compliance...
Confidential
A company is looking for a Clinical Quality Manager to work remotely. Key Responsibilities: Manage and monitor effectiveness of delegation oversight employees and/or supervisors in the West Region Attend and participate in audit meetings,...
