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Part Time Medicare Rac Audit Jobs in Boston, MA (NOW HIRING)

Marquis Health Services

MDS Coordinator

Saugus, MA · On-site

$30 - $60/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Proudly supported by Marquis Health Consulting Services Part-time opportunities available (24 Hrs ... with audit responses and maintain ongoing compliance with Medicare and Medicaid requirements.

HealthQ

Finance Director

Beverly, MA · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

The Finance Director directly supervises a part-time Finance Assistant and provides oversight of ... Lead coordination of financial audits and tax filings, in collaboration with the Administrative ...

HealthQ

Finance Director

Beverly, MA

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

The Finance Director directly supervises a part-time Finance Assistant and provides oversight of ... Lead coordination of financial audits and tax filings, in collaboration with the Administrative ...

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All JobsMedicare Rac Audit JobsPart Time Medicare Rac Audit JobsPart Time Medicare Rac Audit Jobs in Boston, MA

Part Time Medicare Rac Audit information

What is the difference between Part Time Medicare Rac Audit vs Part Time Medicare Claims Processor?

AspectPart Time Medicare Rac AuditPart Time Medicare Claims Processor
Required CredentialsKnowledge of RAC audit procedures, Medicare regulationsUnderstanding of claims processing, coding, Medicare policies
Work EnvironmentRemote or office-based, audit-focusedOffice or remote, claims review and data entry
Employer & Industry UsageHealthcare auditing firms, Medicare contractorsHospitals, insurance companies, healthcare providers

While both roles involve Medicare, Part Time Medicare RAC Auditors focus on reviewing and auditing claims for compliance, whereas Part Time Medicare Claims Processors handle the processing and data entry of claims. The roles differ mainly in their focus—auditing versus claims processing—though both require knowledge of Medicare policies and can be performed remotely or in-office.

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For Part Time Medicare Rac Audit jobs in Boston, MA, the most frequently searched job titles are:

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Part Time Medicare Rac Audit jobs near you

Regional Clinical Reimbursement Specialist-Western and Central MA

CareOne

Concord, MA • On-site

$140K - $155K/yr

Full-time, Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago

CareOne rating

6.8

Company rating: 6.8 out of 10

Based on 30 frontline employees who took The Breakroom Quiz

49th of 242 rated social care providers

Job description


Balance Life & Work with a New Career Opportunity
(LONG TERM CARE)
(SHORT TERM REHAB)
(SKILLED NURSING)
(SUB ACUTE CARE)
NOW HIRING!! Regional Clinical Reimbursement Specialist Western/Central MA
Salary
$140,000. - $155,000 annually
Compensation will be based on, but not limited to, experience, qualifications, credentials and any other relevant information
The Regional Clinical Reimbursement Specialist/MDS plays a crucial role in ensuring the accurate and timely completion of the Minimum Data Set (MDS) assessments for residents in long-term care facilities. This position requires a keen understanding of medical records, clinical, documentation, and compliance with healthcare standards.
The RCRS will be responsible for regularly visiting up to 3-4 CareOne facilities as assigned based on geography.
  • Monitor compliance with the Monthly Billing Reconciliation process
  • Audit the completion and accuracy of MDS's and Care Plans per schedule as required for Medicare, Managed care and OBRA schedules
  • Ensure compliance with State, Federal, and SimpleLTC transmissions and facilitate modifications as needed
  • Facilitate and coordinate with other regional staff as needed
  • Communicate promptly to your supervisor and facility team/regional team any issues or concerns
  • Monitor/Audit the issuance of denial letters, coordination of Medicare certification completion, and nursing documentation to support skilled needs
  • Serve as a resource for the center staff for PDPM and state Medicaid reimbursement guidelines
  • Monitor the compliance of company processes developed to appropriately maximize reimbursement

Position Requirements:
  • Diploma and/or Degree from credentialed school of nursing. Currently licensed as a Registered Nurse in the state of practice
  • Minimum of 5 years of experience in long term care nursing
  • Proven knowledge of quality improvement processes with an emphasis on Medicare, Managed Care and MA Casemix for Skilled Nursing facilities
  • Multi facility experience with management skills
  • Excellent oral and written communication skills
  • Word processing and related computer skills
  • Current licensing and credentials are required

Ideal candidates will possess the following:
  • Passing RAC-CT certification course within 90 days of employment, paid for by CareOne
  • Prior experience in Medicare PDPM Reimbursement and/or MDS experience
  • General knowledge of Managed Care reimbursement systems
  • Excellent ability to work collaboratively with a cross functional healthcare team
  • Basic knowledge of Quality Measures
  • Knowledge of the 5 Star report

About Us
The CareOne mission is to define excellence within the health care community. We are dedicated to Maximizing Patient Outcomes. We treat Residents, their families and each other with respect, dignity and compassion. Through a collaborative and consultative approach, we strive to provide a framework of strength and stability for our Centers and Communities. We work to maintain the highest standards of care and service for Residents, families and our valued employees.
We are proud to Offer the following benefits to Part-time (22.5+ hours/week) and Full-time Employees:
  • Comprehensive Healthcare Benefits
    • Multiple Medical Plans
      • Including Pharmacy
      • Including Teladoc
    • Multiple Dental Plans
    • Vision Plan
    • Health Savings Account (eligibility restrictions apply)
    • Flexible Spending Accounts
    • Voluntary Life and AD&D
    • Short-Term and Long-Term Disability Plans
    • Hospital Indemnity Insurance
    • Critical Illness Insurance
    • Accident Insurance
    • Whole Life Insurance
    • Medicare Employee Assistance
  • Legal Plan
  • Commuter Benefits
  • 401k Retirement Plan
  • Employee Assistance Program (available to all employees)
  • Paid Time Off
    • Vacation
    • Sick Plans in accordance with state laws
  • Opportunities to advance and grow your career

If working with people who are dedicated, compassionate, and concerned about their patients is essential to you, then you'll appreciate being a part of our team. We've built a strong reputation on the outstanding level of care that we provide. We have a graciously appointed facility with strong belief in patient care and service; join us at our beautiful facility!
We are an Equal Opportunity Employer
EEO/AA/M/F/DV

What CareOne employees say

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Hours and flexibility

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About CareOne

Sourced by ZipRecruiter

CareOne is a leading healthcare corporation specializing in senior care, rehabilitation, and assisted living services. Based in Fort Lee, New Jersey, CareOne was established to meet the healthcare requirements of seniors across the state and has expanded its footprint over the years. With its dedication to excellence, CareOne provides a comprehensive range of medical and healthcare services, including post-acute care, long-term and assisted living, memory care, respite care, and more.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Fort Lee, NJ, US

Year founded

1999

Social media

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