Medicare Audit & Appeals Supervisor Job at Baxter (Saint Paul)

Medicare Audit & Appeals Supervisor

As the Medicare Audit & Appeals Supervisor for Baxter Respiratory Health team, y...

Location

United States , Saint Paul

Salary:

68000.00 - 93500.00 USD / Year

Baxter

Expiration Date

Until further notice

Requirements

Respiratory Therapist (RT), Licensed Practical Nurse (LPN), or Registered Nurse (RN) or Paralegal required
Current professional licensure or certification as required by the state of residence
3+ years’ experience in Medicare Audits, Medical Claims, Appeals or Third-Party Reimbursement
1+ years leadership or supervisory experience
Strong critical thinking and problem-solving skills
Knowledge of the various contractors Medicare Fee for Service audits, preferred
Knowledge of Medicare Regulations preferred
Experience with Third Party Compliance preferred
Experience with Durable Medical Equipment provider preferred
Six Sigma Green Belt preferred

Job Responsibility

Directly supervise assigned staff, including on-going performance feedback
Apply corrective measures as appropriate to ensure standards are maintained and goals are achieved
Provide work direction and content expertise to direct reports
Supervise medical reimbursement including Clinical Review for coverage and Medicare Appeals
Prepare and submit pre- and post-payment Audits to Medicare programs
Evaluate and process daily adjustment requests as needed
Assist staff in career development and training
Provide training and mentorship to new team members
Monitor workloads, including daily performance metrics, overdue activities and pending files
Identify and resolve issues on complex patient files

What we offer

Medical and dental coverage starting on day one
Insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance
Employee Stock Purchase Plan (ESPP)
401(k) Retirement Savings Plan with employee contributions and company matching
Flexible Spending Accounts
Educational assistance programs
Paid holidays
Paid time off ranging from 20 to 35 days based on length of service
Family and medical leaves of absence
Paid parental leave

Fulltime

Lead Customer Solution Center Appeals and Grievances RN

The Lead Customer Solution Center Appeals and Grievances RN is responsible for a...

Location

United States , Los Angeles

Salary:

102183.00 - 163492.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Associate's Degree in Nursing for Registered Nurses
At least 8 years of clinical appeals and grievances experience in a managed care, utilization management and/or case management setting
At least 2 years in Medicare/ Medicaid in a managed care/ health plan environment
At least 1 year of leading a process, program, or staff experience
Extensive knowledge of healthcare regulations and managed care guidelines
Strong critical thinking and problem-solving abilities to assess complex clinical cases and evaluate medical necessity
Ability to communication, conflict resolution, and motivational skills
Ability to work independently and closely with a team in a collaborative and interactive environment
Ability to adjust to changing circumstances within the team
Good verbal and written communication skills

Job Responsibility

Assist with the development of a successful and cohesive Appeals and Grievance (A&G) clinical unit
Quality review of complex and/or escalated clinical A&G cases for all line of business (LOB)
Assist in identifying areas of improvement in increasing positive audit outcomes and improved Customer Service
Ensure the effective investigation and resolution of clinical grievances, appeals, complaints, and complex issues in alignment with L.A. Care policy and procedures and regulatory guidelines
Lead and work closely with assigned team daily
Mentor, coach, and may provide feedback to management on performance of staff
Review and process complex and/or escalated clinical A&G cases
Analyze patient medical records, clinical documentation, and insurance policies to determine medical necessity
Prepare and review A&G files for submission to providers and internal departments
Work with other departments to ensure all aspects of a case are appropriately managed

What we offer

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

Fulltime

New

Attorney

We are looking for a skilled (min 3 years) Attorney with a strong background in ...

Location

United States , St. Petersburg

Salary:

100000.00 - 175000.00 USD / Year

Robert Half

Expiration Date

Until further notice

Requirements

Must hold a valid license to practice law in the state of Florida
Minimum of three years of experience in defense litigation and insurance defense
Proficient knowledge of Florida Bar regulations and federal rules of civil procedure
Demonstrated ability to draft motions, briefs, and other legal documents with precision
Strong skills in managing discovery processes and handling evidence
Excellent verbal and written communication abilities
Proven track record of successfully representing clients in litigation
Ability to work on-site initially, with potential for flexibility after probationary period

Job Responsibility

Represent clients in defense litigation cases, including insurance-related matters
Prepare and draft legal motions, briefs, and other essential court documents
Conduct thorough legal research to support case strategies and arguments
Manage the discovery process, including collecting and reviewing evidence
Ensure compliance with Florida Bar regulations and federal civil procedure requirements
Collaborate with colleagues and clients to develop legal strategies tailored to specific cases
Attend court hearings, mediations, and depositions as required
Provide legal counsel and guidance to clients regarding case developments
Maintain detailed records and documentation for all case proceedings
Stay updated on changes to state and federal legal regulations relevant to practice areas

What we offer

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

Fulltime

New

Kitchen Utility Worker

In the role of Kitchen Utility Worker you will help serve meals and clear/wash d...

Location

United States , Hilton Head

Salary:

17.00 - 20.40 USD / Hour

Atria Senior Living

Expiration Date

Until further notice

Requirements

High School education or equivalent
General knowledge of cleaning and sanitation
General knowledge of safe food-handling practices
Effective communication skills in English
Ability and willing to follow standards and procedures, and accept direction & training and work as part of a team

Job Responsibility

Help serve meals and clear/wash dishes from residents’ tables following Holiday procedures
Prepare, wash and store dishes following Holiday procedures
Clean the dishwashing area, food-serving areas and equipment, dining room tables and chairs and vacuum and clean the dining room area
Complete dishwasher temperature log at required times
Assist in the setup of serving carts for each meal
Prepare water carafes and distribute to each table
Serve hot cereal at breakfast and bread at dinner
Help serve meals to residents tables
Deliver trays to residents’ rooms when necessary
Assist with food preparation as assigned

What we offer

Competitive Pay
Paid Holidays & PTO
Comprehensive Health Plans (medical, vision, dental, company paid short term and long term disability, voluntary benefits such as critical illness coverage)
Career Advancement Opportunities
Tuition Reimbursement (up to $5,250 a year)
Employee Loyalty Rewards Program
Retirement Savings Plan with Employer Match (50% match after one year of service)
Rewards & Recognition
Health & Safety

Fulltime

New

Senior Software Engineer

The Microsoft 365 Copilot Mobile team in India is looking for a passionate and t...

Location

India , Noida

Salary:

Not provided

Microsoft Corporation

Expiration Date

Until further notice

Requirements

Bachelor's Degree in Computer Science or related technical field AND 7+ years technical engineering experience with coding in languages including, but not limited to, C, C++, C#, Java, JavaScript, or Python OR equivalent experience
Deep knowledge of Android platforms
Proven skill in postmortem debugging, performance analysis, and experimentation
Excellent interpersonal, verbal, and written communication skills
BS or MS in Computer Science or equivalent
Frameworks & SDK: Strong experience with Android SDK, Jetpack libraries (ViewModel, LiveData, Room, Navigation)
Performance Optimization: Understanding of memory management, battery optimization, and network efficiency
experience with profiling tools like Android Profiler
Testing: Familiarity with JUnit, Mockito for unit testing and Espresso for UI testing
Deployment: Knowledge of Google Play Store publishing, app signing, and release management

Job Responsibility

Lead feature areas: Design, implement, and lead a feature area with a team of 2–5 engineers
Engineer features with strong attention to performance, robustness, and resource efficiency
Work independently and collaboratively across global product teams to deliver end-to-end solutions
Design and implement end-to-end search experiences in the Copilot app, spanning query formulations with various treatments, ranking, and UX
Build high-performance, scalable search components optimized for mobile platforms
Collaborate across disciplines—partner with PMs, designers, and AI experts to deliver context-aware, personalized search
Be data-driven — leverage telemetry and experimentation to maintain high product quality and reach
Drive coherence across Android and iOS platforms, ensuring consistent design and experience
Champion engineering excellence — conduct postmortem debugging, performance analysis, and share best practices

What we offer

Impact at Scale: Shape experiences for millions of users globally
Lead & Influence: Drive technical direction and mentor engineers while working on cutting-edge AI and mobile technologies
Cross-Platform Innovation: Build coherent experiences across Android and iOS
Inclusive Culture: Collaborate with world-class teams in an environment that values innovation, diversity, and growth

Fulltime

New

Cafe Manager

Cafe Managers are central to the success of Blank Street and take full ownership...

Location

United States , Boston

Salary:

Not provided

Blank Street

Expiration Date

Until further notice

Requirements

4+ years of experience managing and leading single-store unit operations in high growth hospitality or consumer brands
Full Time availability: 45 hours per week, 5 days of availability required and must be available to work 2 peak days (usually weekend days, weekend as described as Friday, Saturday, Sunday)
Experience hiring, developing and managing hospitality teams
Experience managing inventory and supply chain ordering
Love for coffee and customer service
Strong knowledge of specialty coffee, espresso and equipment is a must
Strong decision making and multi-taking skills
Strong interpersonal communication skills

Job Responsibility

Create a motivating and engaging team culture by consistently celebrating, training, coaching, and mentoring your team
Step in to cover scheduling gaps or time off in the store schedule
Create and publish staff schedules according to state and local labor laws
Review and approve timecards and paid time off requests in a timely manner ensuring your team is paid accurately and on time
Recruit super star talent in collaboration with the People Team
Oversee and validate the quality of training being executed by your Shift Leads, providing feedback and coaching where needed
Ensure coffee accreditations are handled on time for new employees in line with company standards
Work to maintain the very best team engagement scores
Maintain food and beverage quality standards across your store and ensure recipes are executed accurately and consistently by your team
Own all ordering, vendor relations, waste management, inventory counts and general compliance of our Inventory Management System

What we offer

Bonus program
15 days of paid annual leave (on top of company-observed holidays and sick time)
Three health plan options, with full coverage available for two employee-only tiers
Commuter benefits
Parental leave
Bereavement leave
Exclusive access to our coveted Regulars program – yes, that means free coffee, matcha and more! ☕️
Regular social outings with the team
Free Blank Street swag

Fulltime

New

Account Manager

KARL STORZ Veterinary Endoscopy America (KSVEA) is seeking a driven, customer-fo...

Location

United States , Seattle

Salary:

Not provided

KARL STORZ

Expiration Date

Until further notice

Requirements

Bachelor’s degree in a scientific or business-related field
4–5 years of successful direct sales experience, preferably in a medical or operating room environment or selling capital equipment
Proven, verifiable sales performance (history of meeting or exceeding quota)
Ability to lift up to 40 lbs
Flexibility to travel 50–80%, including some weekends
Valid driver’s license

Job Responsibility

Successfully complete comprehensive in-house and field training programs
Build and continuously improve selling skills, product knowledge, and territory management capabilities
Execute effective territory management strategies to drive sales growth, develop new leads, maintain and expand existing accounts, and increase overall market share
Serve as a trusted consultant to customers, including conducting product demonstrations, preparing quotations, and performing on-site equipment in-servicing after delivery
Collaborate effectively with Account Managers, Associate Account Managers, Sales & Marketing leadership, and back-office teams
Maintain accurate and up-to-date customer and territory records in Salesforce (CRM)
Track competitive activity and communicate insights to Sales and Marketing leadership
Manage territory expenses and inventory responsibly, including all related documentation
Complete all administrative reports accurately and on time
Attend required training courses, meetings, trade shows, and company events

Fulltime

New

Security Engineer WAF & SSLO

The Security Remote Field Service Engineer (L1) is an entry level engineering ro...

Location

India , Mumbai

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

BE/B-Tech/BCA or master’s degree in CS/IT
CCNA/ F5 Certified BIG-IP Admin (F5-CA)/CompTIA Security+/any equivalent OEM certification
2- 3 years’ relevant experience
Adequate knowledge of security devices like Firewalls, DDOS and other security devices
Knowledge of F5, SLB, server pools, virtual servers, health monitors. TCP/IP, DNS, HTTP, and SSL/TLS
Must be prepared to work in a 24/7 shift-based environment

Job Responsibility

Monitor WAF dashboards, logs, and alerts in real-time to detect threats like SQL injections, cross-site scripting (XSS), and DDoS attacks
Perform real-time monitoring of SSLO to ensure the proper decryption and inspection of encrypted traffic by security tools
Conduct daily health checks and status verifications of WAF and SSLO devices and report any hardware or performance issues
Assist in generating daily, weekly, and monthly reports on security incidents and performance trends
Work with other IT teams (e.g., Network, Server, and Application Support) to resolve security-related issues
Respond to security alerts by performing initial analysis and logging incidents or tickets in the ITSM system
Validate security events to differentiate between genuine threats and false positives based on standard operating procedures (SOPs)
Escalate unresolved incidents to the L2/L3 security teams while providing accurate and detailed documentation
Maintain up-to-date and accurate records of incidents, changes, and standard operating procedures (SOPs)
Install application patches and signed software updates in order to improve performance, enable additional functionality or enhance security standard including but not limited to Performing Scans, Management of the system, Updating of plugins and patches, etc.

Fulltime

Medicare Audit & Appeals Supervisor

Baxter

Location:
United States , Saint Paul

Category:
-

Contract Type:
Employment contract

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
March 20, 2025

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