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- ...policies and payer rules across multiple jurisdictions and is able to do multiple types of reviews/audits Preferred Experience: RAC, UPIC, or commercial payer audit response Multi-state Medicaid policy interpretation Expert witness experience in civil litigation Data...SuggestedTemporary workPart timeRemote work
- ...and outpatient auditing (MS-DRGs, CC/MCC validation, POA indicators, PSI/HAC implications), managing external audits (RAC, MAC, OIG, UPIC, commercial payers), and strong knowledge of CMS IPPS/OPPS regulations, OIG Work Plan priorities, Medicare Conditions of...Suggested
- ...management systems as an end user ~ Prior experience on a CMS program integrity, audit, or medical review contract (e.g., MAC, RAC, UPIC, SMRC) Key Responsibilities Perform coding-only medical reviews (no clinical judgment required) on Medicare Part A/B and...SuggestedContract workLocal areaRemote work
- ...benefit, QRP) and accreditation standards (e.g., ACHC, CHAP if relevant). Manage all audits and surveys: plan for and respond to RAC/UPIC requests, state surveys, and internal reviews. Oversee OASIS and HOPE/HIS data quality: review trends, error rates, and implement...SuggestedFull timeWork at office
- ...provider clients. The ideal candidate brings deep knowledge of healthcare reimbursement policies, government audit programs (e.g., RAC, UPIC, MAC), and a proven ability to lead cross-functional and cross-cultural teams at scale. Key Responsibilities Lead and manage the end...SuggestedLocal areaRemote work
- Location: 100% Remote | Duration: Up to 180 Days Organization: Upic Solutions - Nonprofit Technology Partner | Mission-Driven | Community Impact Eligibility: Active-duty U.S. service members within 180 days of separation, with command approval to participate in SkillBridge...SuggestedInternshipRemote work
- ...RHIA) or Registered Health Information Technician (RHIT). • Experience supporting post-payment audit ADR workflows for RAC, MAC, or UPIC reviews. • Experience in a multi-facility health system or revenue cycle consulting environment managing denial operations across...SuggestedContract workWork at officeRemote work
$120k - $130k
...Medicare, Medicaid, Managed Care, Department of Health (DOH), Recovery Audit Contractor (RAC), Unified Program Integrity Contractor (UPIC), and other payer or regulatory audits. Respond to payer requests for additional documentation, medical records, and audit...SuggestedFor contractorsInterim roleImmediate startRemote workAfternoon shift- ...it offers hands-on CRM training and involvement in community impact projects. Responsibilities include processing donations, generating acknowledgments, and ensuring accurate financial records, fostering both career and community growth. #J-18808-Ljbffr Upic SolutionsSuggestedRemote jobInternship
$120k - $150k
...eligibility/recertification documentation standards Hands-on experience with audit preparation (CMS surveys, state surveys, ADRs, ZPIC/UPIC audits), QAPI programs, and corrective action planning Familiarity with major HH&H EHR systems (e.g., HCHB/Homecare Homebase,...SuggestedRemote jobFor contractorsFor subcontractor$350k
...as in-house counsel, at a firm with a real DME practice, or on the government side Experience defending prepayment review, TPE, UPIC, RAC actions Familiarity with the Medicare DMEPOS Competitive Bidding Program Experience as a first legal hire or first-in-function...SuggestedFull timeWork at office- ...individual KPIs, and quality assurance results to drive continuous improvement. Coordinate the execution of audits for government (RAC, UPIC, MAC) and commercial payers , ensuring adherence to payer policies and audit guidelines. Collaborate with the Director of Post-...SuggestedRemote work
- ...and pilot it on all surgical‑dressing claims. Create/upgrade templates for various outreach. Audit & Appeals Lead UPIC/MAC ADR responses (pre‑ and post‑pay). Coach internal billing team; establish a reusable appeals library with policy citations...SuggestedRemote work
Verse Medical
United States5 days ago - Upic Solutions Overview Created in 2001 as a non-profit corporation, our focus is delivering powerful technology and business solutions, empowering our United Way partners to build great relationships with donors and communities, thereby maximizing community impact and...SuggestedPart time
Upic Solutions
Cincinnati, OH2 days ago
