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Affordable Dentures & Implants
Affordable Dentures & Implants
B2CVeselības aprūpe
Affordable Dentures & Implants is a U.S. dental services organization focused on dentures and dental implants. Its clinic network is supported by affiliated implant providers, dental lab technicians, clinical teams, and corporate business services. The company hires across clinical, laboratory, and corporate roles, with a corporate support center in Research Triangle Park, North Carolina.
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Vakances uzņēmumā

Remote Charge Auditor, Payor Relations

Audit healthcare fee schedules, contracted rates, and reimbursement accuracy for U.S. payors. Work with Revenue Cycle Management to identify underpayments and recover missed reimbursements.

USAmerikas Savienotās ValstisFLFloridaILIlinoisaNCZiemeļkarolīnaTXTeksasaAttālinātiPilna slodzeVidējais līmenisVecākais speciālistsNepieciešamā Valoda: angļuRevidents

Apraksts

  • Build and maintain a central repository for every active contract’s fee schedules.
  • Keep fee schedule data current with regulatory changes, payer revisions, and bundled payment terms.
  • Create change logs and governance procedures for contract amendments, rate escalators, and code updates.
  • Compare contracted rate tables with payer agreements, allowable amounts, and internal charge references.
  • Identify and document differences among billed charges, contracted rates, and payments across payer categories.
  • Coordinate with Revenue Cycle Management to reconcile rate tables and fix configuration issues.
  • Investigate underpayments, coding or billing discrepancies, and rate table configuration errors.
  • Run fee schedule audits twice a year to find reimbursement leakage.
  • Correct rate configuration issues, reduce repeat errors, and recover missed payments.
  • Prepare audit findings, trend reports, recommendations, monthly dashboards, and twice-yearly executive reports.
  • Hold quarterly business reviews with strategic payors.
  • Carry out other duties assigned by the Director of Payor Relations.

Prasības

  • A bachelor’s degree in business, finance, healthcare administration, or a related field is required; equivalent experience may substitute.
  • At least three years of experience in charge auditing, revenue cycle management, payer contracting, or a related healthcare finance role.
  • Experience with contracted rate tables, fee schedules, and payer reimbursement methods.
  • Strong analytical and reconciliation abilities, including finding variances and root causes in complex rate data.
  • Advanced Excel skills and proficiency with other data analysis or business intelligence tools.
  • Strong communication skills and the ability to work effectively with Revenue Cycle Management teams.
  • Excellent organization and the ability to establish governance processes and regular reporting schedules.
  • Careful attention to detail and the ability to manage multiple priorities and deadlines independently.
  • Must be authorized to work for any U.S. employer; visa sponsorship is not available.

Saistītās vakances

Guide Healthcare

Registered Nurse Clinical Compliance Auditor

Guide Healthcare
51 – 200 Darbinieki
Personāla atlaseVeselības apdrošināšanaVeselības aprūpe
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82 000 $ – 87 000 $ / gads
AttālinātiPilna slodzeVidējais līmenisVecākais speciālistsNepieciešamā Valoda: angļuRevidents

Audit utilization management, delegated services, and clinical compliance for Guidehealth’s value-based healthcare operations. This remote role supports regulatory readiness and clinical quality.

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BlueCross BlueShield of South Carolina

Auditor II, Medicare Cost Reporting

BlueCross BlueShield of South Carolina
Juridiskie pakalpojumiKonsultācijasVeselības aprūpe
USAmerikas Savienotās ValstisALAlabamaAKAļaskaAZArizonaCAKalifornijaCOKolorādoCTKonektikutaFLFloridaHIHavajasIDAidahoILIlinoisaIAAiovaKSKanzasaKYKentukiLALuiziānaMEMeinaMDMerilendaMAMasačūsetsaMIMičiganaMNMinesotaMSMisisipiMOMisūriMTMontānaNENebraskaNVNevadaNHŅūhempšīraNJŅūdžersijaNMŅūmeksikaNYŅujorkaNCZiemeļkarolīnaNDZiemeļdakotaOHOhaioOKOklahomaOROregonaPAPensilvānijaRIRodailendaSCDienvidkarolīnaSDDienviddakotaTNTenesīTXTeksasaUTJūtaVTVērmontaVAVirdžīnijaWAVašingtonaWIViskonsinaWYVaiominga
49 447 $ – 94 737 $ / gads
AttālinātiPilna slodzeVidējais līmenisVecākais speciālistsNepieciešamā Valoda: angļuRevidents

Conducts financial, compliance, and operational audits for BlueCross Blue Shield of South Carolina, with a focus on Medicare cost reports. Evaluates controls and business risks, recommends corrective actions, and supports remote audits across the United States.

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Cotiviti

Senior Appeals Auditor – Cotiviti (Remote, US)

Cotiviti
5001 – 10 000 Darbinieki
H1B vīzas sponsorsKonsultācijasLoģistikaVeselības aprūpe
USAmerikas Savienotās Valstis
47 $ – 57 $ / stunda
AttālinātiPilna slodzeVecākais speciālistsNepieciešamā Valoda: angļuRevidents

Defend Cotiviti’s recovery decisions by reviewing Medicare claims, clinical records, coding, medical necessity, and provider appeals. Prepare evidence-based appeal responses and support cases progressing to Administrative Law Judge hearings.

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