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Overnight Recovery Audit Contractor Jobs (NOW HIRING)

Montefiore

Senior Compliance Auditor (JR229173)

Bronx, NY

$89K - $110K/yr

Recovery Audit Contractor (RAC) * Zone Program Integrity Contractor (ZPIC) * Health Care Fraud Prevention and Enforcement Action Team (HEAT) * Ensure timely and accurate response to external audit ...

Jzanus Consulting

Nurse Auditor

Garden City, NY · On-site

$87K/yr

Additional Skill Set(s) Required: 1. Coordinates all procedural and other elements related to the Centers for Medicare & Medicaid Recovery Audit Contractor program, commercial payor audits, patient ...

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Government Audit Recovery Specialist

Government Audit Recovery Specialist

Apidel Technologies

Costa Mesa, CA • Remote

Full-time

Posted 23 days ago

Job description

Position Summary:
The Government Recovery Specialist performs duties associated with Centers for Medicare and Medicaid Services (CMS) Recovery Audit Contractor (RAC) program and other government regulatory and enforcement agency audits for documentation and billing compliance. This includes data entry, processing of mail, preparation of audit information, and correspondence with government contractors as needed. This role has a fundamental understanding of the RAC program and other audits for documentation and billing compliance. As an essential role and focal point of all government audit activity, the Government Recovery Specialist is responsible for responding to correspondence from Government Agencies related to Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Targeted Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), Quality Improvement Organizations (QIO) and other Medicaid, Medi-Cal regulatory auditing body for pre and post payment audits.
Skills:
Required Skills & Experience:
3 years of Medicare billing experience in billing, follow up, in an acute care setting.
Experience working on complex projects.
1-3 years of experience in healthcare acute setting regulatory audits and appeals.
Experience with and understanding of CMS billing, payment and reimbursement methodologies.
Knowledge of privacy regulations, security regulations, release of information, CMS rules and regulations.
Proficiency in Microsoft Office applications (Word, PowerPoint, Excel, Outlook).
Preferred Skills & Experience:
5 years of experience or more in an acute setting.
3 years of experience in healthcare acute setting regulatory audits and appeals.
Experience working on government, Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Targeted Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), and other Medicaid, Medi-Cal and other regulatory audits.
5 years of experience in Medicare billing, follow up, appeals.
Knowledge of utilization management process, coding, medical necessity criteria.
3 years of Medicare billing experience in billing, follow up, in an acute care setting
Experience working on complex projects
1-3 years of experience in healthcare acute setting regulatory audits and appeals
Experience with and understanding of CMS billing, payment and reimbursement methodologies
Knowledge of privacy regulations, security regulations, release of information, CMS rules and regulations
Proficiency in Microsoft Office applications (Word, PowerPoint, Excel, Outlook).
Preferred:
5 years of experience or more in an acute setting
3 years of experience in healthcare acute setting regulatory audits and appeals
Experience working on government, Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Targeted Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), and other Medicaid, Medi-Cal and other regulatory audits
5 years of experience in Medicare billing, follow up, appeals
Knowledge of utilization management process, coding, medical necessity criteria
Education:
Required Education:
High school diploma or equivalent experience.
Required Certifications & Licensure:
High school diploma or equivalent experience
Languages:
English
Schedule Notes:
Is this position Remote No Work Location Address: 2995 Red Hill Ave Costa Mesa CA LOA Coverage

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About Apidel Technologies

Sourced by ZipRecruiter

We understand that attracting, qualifying, placing, and retaining the best candidates for our clients requires exceptional talent. That’s why our highly skilled and dedicated recruitment team works tirelessly to develop lifelong associations with all candidates and clients. We prioritize helping our employees achieve their career goals while providing effective staffing solutions to our clients and candidates. At Apidel, we believe in simple yet established core values that are ingrained within each member of our team. These values are time and again illustrated in our approach to employees, candidates, and clients. Our unwavering belief that our core values of integrity, client satisfaction, innovation, and intellect distinguish us from our competitors is what drives us forward. We remain focused on improving and sustaining a measurable client satisfaction program that has created an organizational culture where our associates provide world-class service every day.

Industry

Recruiting and staffing services

Company size

501 - 1,000 Employees

Headquarters location

Plainfield, IL, US

Year founded

2012

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