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Government Audit Recovery Specialist

Integrated Resources, Inc

Costa Mesa, CA

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JOB DETAILS
JOB TYPE
Contractor
SKILLS
Acute Care, Apple Macs, Auditing, Billing, Billing Records, Centers for Medicare and Medicaid Services (CMS), Content Management Systems (CMS), Data Entry, Government, Government Contracts, Government Regulations, Healthcare, Mail Processing, Medi-Cal, Medicaid, Medical Billing, Medical Coding, Medicare, Microsoft Excel, Microsoft Office, Microsoft Outlook, Microsoft PowerPoint, Microsoft Word, Organizational Development/Management, Privacy Controls, Privacy Regulations, Quality Management, Regulations, Reimbursement, Testing, Training/Teaching, Utilization Management
LOCATION
Costa Mesa, CA
POSTED
20 days ago
100% Onsite role - Only Locals from Orange County OR within 25 miles from Costa Mesa Position Summary: The Government Recovery Specialist performs duties associated with Centers for Medicare and Medicaid Services (CMS) Recovery Audit Contractor (RAC) program and other government regulatory and enforcement agency audits for documentation and billing compliance. This includes data entry, processing of mail, preparation of audit information, and correspondence with government contractors as needed. This role has a fundamental understanding of the RAC program and other audits for documentation and billing compliance. As an essential role and focal point of all government audit activity, the Government Recovery Specialist is responsible for responding to correspondence from Government Agencies related to Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Cliented Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), Quality Improvement Organizations (QIO) and other Medicaid, Medi-Cal regulatory auditing body for pre and post payment audits The Government Recovery Specialist performs duties associated with Centers for Medicare and Medicaid Services (CMS) Recovery Audit Contractor (RAC) program and other government regulatory and enforcement agency audits for documentation and billing compliance. This includes data entry, processing of mail, preparation of audit information, and correspondence with government contractors as needed. This role has a fundamental understanding of the RAC program and other audits for documentation and billing compliance. As an essential role and focal point of all government audit activity, the Government Recovery Specialist is responsible for responding to correspondence from Government Agencies related to Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Cliented Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), Quality Improvement Organizations (QIO) and other Medicaid, Medi-Cal regulatory auditing body for pre and post payment audits. Required Skills & Experience: 3 years of Medicare billing experience in billing, follow up, in an acute care setting Experience working on complex projects. -1-3 years of experience in healthcare acute setting regulatory audits and appeals. Experience with and understanding of CMS billing, payment and reimbursement methodologies. Knowledge of privacy regulations, security regulations, release of information, CMS rules and regulations. Proficiency in Microsoft Office applications (Word, PowerPoint, Excel, Outlook). Preferred Skills & Experience: 5 years of experience or more in an acute setting. 3 years of experience in healthcare acute setting regulatory audits and appeals. Experience working on government, Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Cliented Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), and other Medicaid, Medi-Cal and other regulatory audits. 5 years of experience in Medicare billing, follow up, appeals. -Knowledge of utilization management process, coding, medical necessity criteria. Required Education: High school diploma or equivalent experience.

About the Company

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Integrated Resources, Inc