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

Account Executive, Uber Direct - France

This role will be a part of the Uber Direct team in France, and will be working ...

Location

France , Paris

Salary:

Not provided

Uber

Expiration Date

Until further notice

Requirements

3+ years in a Sales, Business Development, Account Management, preferably with exposure to e-commerce, delivery or logistics topics and/or in a start-up / scale-up / fast-growing environment
Experience in the full B2B sales cycle: prospecting, pitching, negotiating & closing
demonstrated resilience and grit when working with enterprise merchants on long sales cycle
Proven ability to prioritize across selling activities and follow through in a timely fashion
Empathetic when dealing with different people
able to quickly build relationships with external and internal partners
Good communication and interpersonal skills, with the ability to persuasively communicate recommendations and effectively champion customer needs
Great commercial intuition, business acumen and judgment. Comfortable dealing with financial information and thoughtful about overall strategic choices. Ability to negotiate pricing with a focus on retaining value
Proactive mindset, proven ability to take initiatives and highly autonomous - able to work with minimal supervision
Entrepreneurial mindset and pro-activity. Comfortable navigating ambiguity and building in "start-up within a scale-up" environments. High adaptability to change and ability to execute quickly

Job Responsibility

Develop the go-to-market strategy to grow our business within your vertical
Develop account plans to grow pipeline and break into whitespace accounts for Uber Direct
Lead and coordinate end-to-end sales motion for mid-market and enterprise Direct prospects including qualification, education, pricing/quoting, contract negotiation to close deals
Build strategic and long-term relationships to gain positioning with decision-makers while driving growth of Direct business within key mid-market and enterprise prospects
Advise merchants on their customer delivery journey and guide them to customize the delivery experience for their customers
Communicate the value of Uber Direct to prospect accounts. Seek and achieve logistics, same-day delivery, delivery-as-a-service industry knowledge to have enriching conversations with them
Collaborate with operations and tech teams to build a compelling offering for each merchant, incl. new delivery capabilities and custom integrations features
Leverage channel partners to accelerate Direct penetration within their merchants portfolio
Contribute to Uber Direct offering improvement. Identify ways to develop further Uber Direct offering to answer merchants’ needs and build business case to unlock ops & product development

New

Internal Auditor I Senior

Under direction of Audit Services Leadership, oversees the timely execution of r...

Location

United States , Charlotte

Salary:

41.10 - 61.65 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Bachelor's degree in accounting, finance, auditing, information systems or related field required
3-5 years of related work experience in provider healthcare, internal auditing or a related field such as accounting
Must possess moderate knowledge and understanding of internal auditing, accounting, technology, data analytics, healthcare compliance, and business principles

Job Responsibility

Understands business processes and activities in order to appropriately determine risks
develops audit budgets, objectives and procedures
identifies findings and root causes
concludes as to the adequacy of internal controls
recommends opportunities for improvement
and evaluates leadership action plans
Conducts approved audit testing (interviews, document review, flowcharting, data analysis) to identify reportable issues for an audit project
Proficient in effective oral and written communications that require moderate correction, rework or rewrite by supervisors
Prepares audit work papers in accordance with departmental standards including timeliness, use of templates, and documentation location and which result in moderate review notes
Completes assigned projects on time (meets both budget hours & milestone dates)

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

New

Operations and Strategy Manager, Driver Growth LatAm

The Driver Growth team's mission is to build the engine that powers it: the supp...

Location

Salary:

Not provided

Uber

Expiration Date

Until further notice

Requirements

3+ years of professional and demonstrated experience
Data-driven mentality
Proficiency in data analysis, generating data insights
Portuguese or Spanish and English proficiency
Demonstrated experience interpreting and presenting data to various audiences

Job Responsibility

Lead regional efforts to scale Uber Moto supply across LatAm
Plan and organize complex, multi-faceted projects with cross-functional teams
Identify and activate key levers to drive Uber Moto adoption
Perform deep-dive in Moto growth metrics, interpret trends and generate solutions
Maintain a pulse on Moto supply performance
Act as the voice of the LatAm market to Global Product teams
Implement, optimize, and scale core analyses and earner-facing processes across LatAm

New

Assistant director of development - philanthropy, comprehensive cancer center

The Assistant Director of Development - Philanthropy, Comprehensive Cancer Cente...

Location

United States , Winston Salem

Salary:

47.50 - 71.25 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Bachelor’s degree
five years of fundraising experience, including major gifts
experience leading volunteer fundraising boards
ability to work in a complex environment with the personal and technical skills necessary to establish priorities, set objectives, and achieve goals
adeptness in working with high net worth individuals and faculty/physicians
excellent written and oral communication skills
strong leadership and interpersonal skills
ability to relate research and program goals to external audience
capacity to build and maintain long-term relationships
proven presentation abilities

Job Responsibility

Serves as the philanthropic leader for Atrium Health Wake Forest Baptist’s Comprehensive Cancer Center
reports to the Director of Major Gifts
maintains a close working relationship with the Director of the Comprehensive Cancer Center, Director of the Cancer Clinical Service Line and section heads for Hematology/Oncology, Radiation Oncology and Surgical Oncology
supervises at least one Major Gift Officer
leads the cancer fundraising effort on behalf of the Medical Center including raising funds that support education, research, patient aid, and clinical care
develops a philanthropic plan for the Comprehensive Cancer Center and provides strategic oversight of the plan
identify, cultivate, and solicit individuals for major gifts ($50K+) and leadership gifts ($1M+) to the Center
build and maintain a portfolio high-profile prospects
develop strategies for solicitations
work with research, annual funds, events, and special gifts teams to establish and implement strategies for identifying and qualifying major gifts prospects

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Opportunity for annual increases based on performance

Fulltime

New

Account Manager SMB

The Account Manager role is a fantastic opportunity to showcase your relationshi...

Location

Chile , Santiago

Salary:

Not provided

Uber

Expiration Date

Until further notice

Requirements

1-3 years of experience, ideally in a similar role
Confidence in making data-driven decisions and applying sound business judgment
Strong project management skills, with the ability to develop detailed joint business plans with partners and consistently deliver results
Excellent communication skills, both verbal and written, with strong executive presence and interpersonal abilities
A proactive, resourceful, and go-getter attitude
Ability to work independently with minimal oversight
A willingness to work hard, dive into details, and closely collaborate with our highest-value partners
Experience in customer-facing roles with a proven track record of achieving business targets or meeting quotas

Job Responsibility

Lead post-deal partner management for a high-value, high-potential portfolio of restaurant partners
Build and maintain strong partner relationships to achieve measurable outcomes, including revenue growth targets, upselling new product features, and ensuring high retention by creating mutual business value
Act as the voice of the customer to internal teams, translating partner needs and advocating on their behalf
Develop a deep understanding of the partner landscape and cultivate positive relationships across our restaurant partner organizations
Conceive, design, and lead growth initiatives with restaurant partners, working cross-functionally with Uber’s internal teams to drive projects to completion
Set, track, and report on performance metrics, and conduct business reviews with partners

New

Software Engineer II- Backend

Collaborates with stakeholders within the team to build and maintain backend ser...

Location

United States , New York; Seattle; San Francisco; Sunnyvale

Salary:

171000.00 - 190000.00 USD / Year

Uber

Expiration Date

Until further notice

Requirements

Bachelor’s degree or equivalent in Computer Science, Engineering, Mathematics or related field with at least 1 year of full-time Software Engineering work experience OR PhD in Computer Science, Engineering, Mathematics or related field
Proficiency in at least one programming language such as Java, C++, Python, or Go
1 year of experience with backend development, building and delivering end-user products.

Job Responsibility

Design, develop, and maintain robust and scalable software solutions
Collaborate with product managers, cross-engineering teams, data scientists and other partners to gather requirements and translate them into technical specifications
Identify opportunities and lead of the entire development lifecycle end-to-end, from architecture design and coding to deployment
Conduct thorough code reviews, offering constructive feedback to maintain high code quality and elevate coding standards
Stay up-to-date with the latest technologies and industry trends, evaluating their potential impact on our software systems and recommending appropriate integrations or improvements
Participate in periodic on-call rotations and be available for critical issues

What we offer

Eligible to participate in Uber's bonus program
May be offered an equity award & other types of comp
Eligible for various benefits

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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