Current jobs related to RN Hospital Bill Audit/Appeal Lead - Tampa, Florida - Elevance Health
-
RN Hospital Bill Audit/Appeal Lead
4 weeks ago
Tampa, Florida, United States Elevance Health Full timeJob SummaryWe are seeking a highly skilled RN Hospital Bill Audit/Appeal Lead to join our team at Elevance Health. As a key member of our Payment Integrity line of business, you will be responsible for leading a team of clinicians in identifying and analyzing aberrant patterns of utilization and/or fraudulent activities by healthcare providers.Key...
-
Physician Coding and Billing Lead
3 weeks ago
Tampa, Florida, United States Sherloq Solutions Full timeWe are seeking an experienced Coding and Compliance Specialist to lead our physician coding, billing, and follow-up team.The ideal candidate will have extensive knowledge of CPT-4 and ICD-10 coding, as well as a strong understanding of the professional medical billing, denials and appeals processes.This position requires strong organizational,...
-
Controller, Revenue and Billing Lead
3 weeks ago
Tampa, Florida, United States ImageNetLLC Full timeJob OverviewImaginet LLC is seeking an experienced Controller, Revenue and Billing to oversee the billing, revenue recognition, and forecasting process for the organization across multiple legal entities.The successful candidate will play a key role in managing the billing team, leading the monthly revenue recognition process, and collaborating closely with...
-
Audit Team Lead
3 weeks ago
Tampa, Florida, United States Spartan Placements, LLC Full timeJob OverviewWe are seeking a highly skilled Audit Team Lead to join our team at Spartan Placements, LLC. As a key member of our audit team, you will be responsible for overseeing multiple engagements and teams concurrently, allocating responsibilities to staff auditors, and reviewing team members' work for accuracy and compliance.Key Responsibilities:Lead...
-
Healthcare Finance Director
4 weeks ago
Tampa, Florida, United States Tampa General Hospital Full timeDirector, ReimbursementTampa General Hospital seeks a seasoned professional to lead our reimbursement strategy and ensure financial viability.Key Responsibilities:Develop and implement strategic initiatives to maximize reimbursement and drive financial growth.Manage and review annual Medicare, FHURS, and other regulatory reports to ensure compliance and...
-
Tampa, Florida, United States Sherloq Solutions Full timeAbout Sherloq SolutionsSherloq Solutions is a leading provider of revenue cycle services, dedicated to delivering exceptional results in the healthcare industry. Our team is passionate about helping healthcare providers and payers maximize their revenue and improve patient outcomes.Job SummaryWe are seeking a highly skilled Medical Billing Specialist,...
-
Tampa, Florida, United States Sherloq Solutions Full timeJob DescriptionSherloq Revenue Solutions is seeking a highly skilled Medical Billing Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for resolving healthcare claims through verbal or online inquiries to health insurance payers.Key ResponsibilitiesEffectively navigate and utilize various healthcare provider...
-
Reimbursement Strategist
3 weeks ago
Tampa, Florida, United States Tampa General Hospital Full timeReimbursement StrategistUnder the general supervision of the VP of Reimbursement, the Reimbursement Strategist provides financial viability to Tampa General Hospital by instituting strategic initiatives that position the system to maximize reimbursement and trace these initiatives. The Strategist ensures that these processes are supported by published...
-
Medical Insurance Billing Specialist
4 weeks ago
Tampa, Florida, United States Florida Urology Partners Full timeMedical Insurance Billing and Collections ExpertWe are seeking a highly skilled Medical Insurance Billing and Collections Expert to join our team at Florida Urology Partners. As a key member of our team, you will be responsible for analyzing daily denials and aging accounts, updating and working insurance accounts, and communicating with our manager on...
-
Medical Insurance Billing Specialist
4 weeks ago
Tampa, Florida, United States Florida Urology Partners LLP Full timeJob OpportunityWe are seeking a highly skilled Medical Insurance Billing and Collections expert to join our team at Florida Urology Partners LLP. This is a full-time position that offers a competitive salary and excellent benefits.Key Responsibilities:Analyze daily denials and aging accounts to resolve issuesUpdate and work insurance accounts via worklist or...
-
Tampa, Florida, United States Sherloq Solutions Full timeWe are seeking a skilled Medical Billing Specialist to join our team at Sherloq Revenue Solutions. This full-time position is part of our Insurance Revenue Cycle department, where you will play a crucial role in resolving healthcare claims and ensuring accurate billing and reimbursement.Key Responsibilities:Resolve healthcare claims through verbal or online...
-
Tampa, Florida, United States Sherloq Solutions Full timeJob DescriptionSherloq Revenue Solutions is seeking a Medical Billing Specialist, Insurance Revenue Cycle to join our team. As a key member of our revenue cycle team, you will be responsible for resolving healthcare claims through verbal or online inquiries to health insurance payers.Key Responsibilities:Resolve healthcare claims through verbal or online...
-
Audit Manager
4 weeks ago
Tampa, Florida, United States Crete Professionals Alliance Full timeJob Title: Audit ManagerWe are seeking a highly skilled and experienced Audit Manager to join our team at Crete Professionals Alliance. As an Audit Manager, you will play a key role in leading our audit teams and providing expert advice to our clients.Key Responsibilities:Manage a portfolio of clients and lead audit teams to deliver high-quality...
-
Audit Director
4 weeks ago
Tampa, Florida, United States RSM US LLP Full timeJob SummaryWe are seeking a highly skilled and experienced Audit Manager to join our team at RSM US LLP. As an Audit Manager, you will be responsible for leading audit teams and providing high-quality client service that meets or exceeds client expectations.Key ResponsibilitiesLead audit teams and coordinate the auditing of financial statements, related...
-
Audit Manager
3 weeks ago
Tampa, Florida, United States CyberCoders Full timeJob Title: Audit ManagerWe are seeking a highly skilled and experienced Audit Manager to join our team at CyberCoders. As an Audit Manager, you will be responsible for leading and managing the overall audit process for clients, including planning, execution, and reporting.Key Responsibilities:Lead and manage the audit process for clients, ensuring accuracy...
-
Audit Manager
4 weeks ago
Tampa, Florida, United States Citigroup Full timeAbout the RoleCitigroup is seeking a highly skilled and experienced Audit Manager to join our team. As an Audit Manager, you will be responsible for leading a team of internal auditors in conducting risk-based audits and assessments of Citigroup's risk and control environments.Key ResponsibilitiesDevelop and execute audit plans to ensure effective risk...
-
Audit Manager
4 weeks ago
Tampa, Florida, United States Citigroup Inc Full timeJob Title: Internal Audit ManagerThe Internal Audit Manager is a critical role responsible for leading moderately complex audits and assessments of Citigroup's risk and control environments. This position requires in-depth subject matter expertise to ensure that the firm meets audit standards and regulations.Key Responsibilities:Develop, execute, and deliver...
-
Audit Manager
2 weeks ago
Tampa, Florida, United States Cherry Bekaert Full timeAbout the Role:Cherry Bekaert is seeking an experienced Audit Manager to join our team in Tampa, FL. As an Audit Manager, you will be responsible for leading audit engagements, managing teams, and providing guidance to associates.Key Responsibilities:Lead audit engagements and manage teams to ensure successful completionProvide guidance and support to...
-
Audit Director
4 weeks ago
Tampa, Florida, United States RSM Global Full timeJob Title: Audit ManagerWe are seeking a highly skilled and experienced Audit Manager to join our team at RSM Global. As a key member of our nonprofit assurance practice, you will be responsible for leading audit engagements and providing exceptional client service.Responsibilities:Lead audit engagements and coordinate the auditing of financial statements,...
-
Audit Manager
2 months ago
Tampa, Florida, United States Forvis Mazars, LLP Full timeJob SummaryWe are seeking a highly skilled and experienced Audit Manager to join our team at Forvis Mazars, LLP. As an Audit Manager, you will be responsible for leading audit engagements, reviewing procedures, and providing expert advice to clients.Key ResponsibilitiesLead audit engagements and ensure timely completionReview and improve audit procedures to...
RN Hospital Bill Audit/Appeal Lead
2 months ago
We are seeking a highly skilled RN Hospital Bill Audit/Appeal Lead to join our team at Elevance Health. As a key member of our Payment Integrity line of business, you will be responsible for leading a team of clinicians in identifying and addressing aberrant patterns of utilization and/or fraudulent activities by healthcare providers.
Key Responsibilities- Develop and maintain the claims review process to ensure accuracy and efficiency.
- Collaborate with management to develop unit goals, policies, and procedures.
- Investigate potential fraud and over-utilization through complex medical reviews and post-payment auditing.
- Correlate review findings with appropriate actions, including provider education, recovery of monies, cost avoidance, and recommending sanctions or other actions.
- Act as a liaison with Service Operations and other areas of the corporation relative to claims reviews and their status.
- Train and provide guidance to nurse auditors and manage workflow and priorities for the unit.
- AS in nursing and minimum of 5 years of clinical experience and minimum of 2 years of claims review experience.
- Current unrestricted RN license in applicable state(s) required.
- Ability to travel to worksite and other locations as necessary.
- BA/BS preferred.
- Knowledge of auditing, accounting, and control principles and working knowledge of CPT/HCPCS and ICD 10 coding and medical policy guidelines strongly preferred.
- Certification as a Professional Coder preferred.
- Hospital Bill Audit Experience preferred.
- Itemized Bill Review Experience preferred.
- Hospital Bill Audit/Itemized Bill Review Appeal Experience preferred.
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact HR@ElevanceHealth.com for assistance.
