Audit & Reimbursement II Job at Elevance Health (Multiple locations)

Pharmacy Tech II

Performs the duties of a Technician Pharmacy I and II as required. Performs the ...

Location

United States , Albuquerque

Salary:

17.86 - 26.78 USD / Hour

UNM Hospitals

Expiration Date

Until further notice

Requirements

High School or GED Equivalent
Training
Complete Hospital Pharm Tech Training or Equiv
1 year directly related experience
Certified Pharmacy Technician in NM w/in 60 days
National Board Pharmacy Technician Certification w/in 60

Job Responsibility

Performs the duties of a Technician Pharmacy I and II as required
Performs the duties under the supervision of a licensed pharmacist
Inpatient to include tasks such as answering the pharmacy phones, triaging medication requests, delivering replenishments including controlled substances and patient specific medications
Outpatient to include tasks such as answering pharmacy phone line, learning and becoming efficient with the pharmacy management system by entering patient information, allergies, prescription information, and filling prescriptions
Pharmacy technician shall understand medical and pharmaceutical terminology, symbols, and abbreviations used in the practice of pharmacy
Ensure adherence to Hospitals and departmental policies and procedures
Patient care assignment may include neonate, pediatric, adolescent, adult and geriatric age groups
DATA - Enter various data into computer and forms, verify data, make corrections and ensure accuracy
INVENTORY – Order medications from wholesaler and put order on pharmacy shelf when received
Load medication into distribution/dispensing technological solutions

What we offer

Receive 17% Weekday Nights, 26% Weekend Nights and 15% Weekend Day shift differentials
Sign-On Bonus Available
Tuberculosis testing is completed upon hire and additionally as required

Fulltime

Project Financial Assistant I-II

Under the supervision of the Lead Project Financial Assistant (PFA), Project Fin...

Location

United States , Arvada

Salary:

22.00 - 28.00 USD / Hour

Souder Miller & Associates

Expiration Date

Until further notice

Requirements

High school diploma or GED required
Minimum of 2 years' related experience or the equivalent thereof
Must have a valid driver's license and acceptable driving record
Must be able to pass drug and alcohol test
Candidates must be authorized to work in the United States without current or future sponsorship

Job Responsibility

Accurately and completely initialize projects in the company financial system
Assists with budget in the financial systems
Works closely with Project Managers to ensure early warning of potential over-runs
Re-allocates budgets as required
Prepares billing reviews, draft invoices, and monthly reports for PM's monthly to review and ensure that all charges are in the correct phases and/or time is accurately charged
Provides analysis of Work in progress (WIP), billings, collections and receivables
Assists Project Manager (PM) in tracking out-of-scope work to ensure that change orders are prepared and executed when needed
Prepares and distributes weekly/monthly office reports and drive actions to resolve indicated issues
Prepares invoices with the goal of billing every project every month
Drives action to bring number of days billings in WIP and accounts receivables (AR) to company goal

What we offer

Health
Dental
Vision
401K Retirement Plan
Employee Stock Options (ESOP)
Life/ADD/Short Term/Long Term Insurance
ID Theft Protection
Voluntary Insurance
FSA
Dependent Care

Fulltime

Administrative Assistant II - Surgery

The Department of Surgery at Mount Sinai Health System is seeking a highly organ...

Location

United States , New York

Salary:

23.00 - 36.00 USD / Hour

Mount Sinai Health System

Expiration Date

Until further notice

Requirements

Associates degree or equivalent combination of experience (Bachelors preferred)
4+ years related administrative or business experience
Prior administrative, healthcare, academic, nonprofit, or global health experience preferred
Strong organizational and multitasking skills with high attention to detail
Excellent written and verbal communication skills
Ability to work independently while managing multiple competing priorities
Comfortable interacting with individuals from diverse cultural and professional backgrounds
Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) and virtual meeting platforms
Experience with travel coordination, reimbursements, or academic administration preferred
Flexibility to occasionally support meetings or communications outside standard business hours due to international collaborations

Job Responsibility

Provide administrative support for the Department’s Global Health Initiative and International Surgical Center collaborations
Coordinate calendars, meetings, conference calls, and virtual sessions across multiple international time zones
Prepare meeting agendas, take minutes, and distribute follow-up action items
Assist with scheduling international visitors, faculty meetings, trainee activities, and educational sessions
Maintain organized records, tracking documents, and program databases
Assist with travel logistics for students, trainees, faculty, and international visitors, including flights, lodging, itineraries, and reimbursement documentation
Support visa-related administrative processes and collection of required documentation
Help coordinate onboarding materials and orientation information for international visitors and trainees
Assist in organizing cultural humility and pre-travel educational sessions for global health participants
Coordinate communications with international partner sites and stakeholders

Fulltime

Utilization Management Claims Review Nurse Rn Ii

The Utilization Management (UM) Claims Review Nurse RN II is responsible for con...

Location

United States , Los Angeles

Salary:

88854.00 - 142166.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Associate's Degree in Nursing
At least 5 years of experience in Clinical Nursing
At least 3 years of experience with Medi-Cal and Medicare in a managed care environment
Experience in performing and creating clinical documentation
Experience in regulatory compliance for a health plan
Registered Nurse (RN) - Active, current and unrestricted California License
Knowledge of medical necessity criteria, reimbursement principles, and managed care operation
Working knowledge of clinical policies
Working knowledge of CPT/HCPC Codes, and ICD-10
Proficient in claims processing systems and electronic medical record platforms

Job Responsibility

Perform claims pre-payment review
Conduct comprehensive retrospective reviews
Complete Provider Dispute Review (PDR) clinical evaluations
Apply internal and external clinical policies
Monitor trends related to contested claims and identify potential FWA concerns
Collaborate with internal teams to support payment integrity initiatives
Provide clear, well-documented clinical rationales supporting approval, denial, or adjustment decisions
Maintain productivity and quality standards
Participate in audits, regulatory readiness activities, and quality improvement initiatives
Document review outcomes clearly and accurately

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

Pharmacy Tech II

Performs the duties of a Technician Pharmacy I and II as required. Performs the ...

Location

United States , Albuquerque

Salary:

17.86 - 26.78 USD / Hour

UNM Hospitals

Expiration Date

Until further notice

Requirements

High School or GED Equivalent
Training
Complete Hospital Pharm Tech Training or Equiv
1 year directly related experience
Certified Pharmacy Technician in NM w/in 60 days
National Board Pharmacy Technician Certification w/in 60

Job Responsibility

Performs the duties of a Technician Pharmacy I and II as required
Performs the duties under the supervision of a licensed pharmacist
Inpatient to include tasks such as answering the pharmacy phones, triaging medication requests, delivering replenishments including controlled substances and patient specific medications
Outpatient to include tasks such as answering pharmacy phone line, learning and becoming efficient with the pharmacy management system by entering patient information, allergies, prescription information, and filling prescriptions
Pharmacy technician shall understand medical and pharmaceutical terminology, symbols, and abbreviations used in the practice of pharmacy
Ensure adherence to Hospitals and departmental policies and procedures
Patient care assignment may include neonate, pediatric, adolescent, adult and geriatric age groups
DATA - Enter various data into computer and forms, verify data, make corrections and ensure accuracy
INVENTORY – Order medications from wholesaler and put order on pharmacy shelf when received. Load medication into distribution/dispensing technological solutions
MAINTENANCE - Assist with the implementation and maintenance of software and hardware associated with Pyxis, RxRobot, Optifill and other departmental systems

What we offer

Sign-On Bonus Available
17% Weekday Nights differential
26% Weekend Nights differential
15% Weekend Day shift differentials

Fulltime

Accountant II

A growing organization is seeking a detail‑oriented Accountant II to support key...

Location

United States , Omaha

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Bachelor’s degree in Accounting, Finance, or a related discipline required
Minimum of three years of progressive accounting experience
Strong Excel skills and high attention to detail
Ability to prioritize, work independently, and meet deadlines
Professional communication skills and comfort working with internal and external stakeholders

Job Responsibility

Support the preparation, review, and analysis of financial statements, internal reports, and regulatory filings
Review and resolve discrepancies in financial entries, schedules, and supporting documentation
Compile, reconcile, and analyze financial data to ensure transactions are recorded accurately and in alignment with accounting policies
Prepare financial schedules and analysis used to evaluate current performance and forecast future activity
Assist with cash flow reporting across multiple entities
Prepare various tax- and compliance‑related filings, including estimates, assessments, and annual returns for multiple jurisdictions
Provide backup support for accounts payable, including voucher processing, vendor payments, expense reimbursements, and daily balancing
Assist with accounting and reporting processes related to reinsurance or other specialty financial programs, including generating routine reports
Monitor compliance with GAAP, statutory accounting requirements, and internal procedures
Partner with internal departments to troubleshoot issues, improve processes, and support efficient information flow

What we offer

medical, vision, dental, and life and disability insurance
company 401(k) plan

Pharmacy Tech II

Performs the duties of a Technician Pharmacy I and II as required. Performs the ...

Location

United States , Albuquerque

Salary:

17.86 - 26.78 USD / Hour

UNM Hospitals

Expiration Date

Until further notice

Requirements

High School or GED Equivalent
Complete Hospital Pharm Tech Training or Equiv
1 year directly related experience
Certified Pharmacy Technician in NM w/in 60 days
National Board Pharmacy Technician Certification w/in 60
Heavy Work: Exerting 50 to 100 pounds of force occasionally, and/or 25 to 50 pounds of force frequently, and/or 10 to 20 pounds of force constantly to move objects or people
Sig Hazard: Chemicals, Bio Hazardous Materials req PPE
Tuberculosis testing is completed upon hire and additionally as required

Job Responsibility

Performs the duties of a Technician Pharmacy I and II as required
Performs the duties under the supervision of a licensed pharmacist
Inpatient to include tasks such as answering the pharmacy phones, triaging medication requests, delivering replenishments including controlled substances and patient specific medications
Outpatient to include tasks such as answering pharmacy phone line, learning and becoming efficient with the pharmacy management system by entering patient information, allergies, prescription information, and filling prescriptions
Pharmacy technician shall understand medical and pharmaceutical terminology, symbols, and abbreviations used in the practice of pharmacy
Ensure adherence to Hospitals and departmental policies and procedures
Patient care assignment may include neonate, pediatric, adolescent, adult and geriatric age groups
DATA - Enter various data into computer and forms, verify data, make corrections and ensure accuracy
INVENTORY – Order medications from wholesaler and put order on pharmacy shelf when received. Load medication into distribution/dispensing technological solutions
MAINTENANCE - Assist with the implementation and maintenance of software and hardware associated with Pyxis, RxRobot, Optifill and other departmental systems

What we offer

Sign-On Bonus Available
Receive 17% Weekday Nights, 26% Weekend Nights and 15% Weekend Day shift differentials
Dependent Education Scholarships

Fulltime

Health Information Management Coding Educator II

The Health Information Management Coding Educator II provides support and coding...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

High School diploma or equivalent years of experience required
Bachelor's Degree in HIM or 5 years experience in a complex healthcare or medical office setting preferred
Experience conducting training/educational sessions for professional coding staff, including preparations of instructional materials, is preferred
Extensive knowledge of Health Information Management systems (e.g., Epic, Meditech, 3M/360 CAC, OneContent, etc.) and legal health record documentation components and practices
Experience working in an integrated healthcare delivery system is preferred
Experience with physician documentation and audit experience is preferred
RHIA (Registered Health Information Administrator (AHIMA), or RHIT (Registered Health Information Technician (AHIMA) or CCS Certified Coding Specialist (AHIMA) credential required

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Onboard, train, and orient new hires to CHRISTUS Coding systems, workflows, and practices
Facilitate and/or instruct associates in coding education programs such as monthly inpatient and outpatient coding roundtables and coding updates as relevant to health information management including documentation requirements, accurate coding, modifier assignment, compliance and data management
Advises associates about their coding performance, suggest educational curriculum in training academy and maintains attendance rosters and coder performance trends on assessment exams
Work collaboratively with Coding Integrity and Coding Compliance to develop job aides and educational resources regarding important coding concepts and to advise on important topics related to coding guidelines and changing trends
Reviews audit results and performs trend analyses and sends completion reports to report educational findings and opportunities. Incorporates findings into educational events such as coding roundtables and section meetings as requested
Serves as a resource for department leadership, staff, physicians, and administration to obtain education, training or information on accurate and ethical coding and documentation standards, guidelines, and regulatory requirements
Ensures maintenance of attendance rosters and documentation (agenda, job aids) for HIM training programs
Ensure instruction of associates is streamlined, appropriate and effective with an interest in productivity and efficiency. Assesses course effectiveness through associate evaluations and surveys
Performs additional duties to cover in the absence of the Education Manager in areas such as 3M/360 testing, coding updates and providing the “all-clear” at times of system updates. Reviews and managers education platform by presenting utilization reports and trends. Collect and regularly reports qualitative data about the HIM Coding Department and Educational efforts

Fulltime

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Audit & Reimbursement II

Job Description

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