- RWJBarnabas Health (Oceanport, NJ)
- …and DRG assignment for adherence to Federal and State Regulations and Compliance Guidelines. + Critically analyzes each Medicare inpatient medical record ... sustain an excellent organizational average accuracy rate. Adherance to applicable Federal and State Regulations, Compliance Guidelines, and Coding Guidelines… more
- Humana (Trenton, NJ)
- …a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse scope and...necessity of services provided by other healthcare professionals in compliance with coverage policies, procedures, and performance standards. CMD… more
- Public Consulting Group (Trenton, NJ)
- …learn more, visit www.publicconsultinggroup.com . Duties & Responsibilities . Prepare Medicare and/or Medicaid cost reports for ambulance providers. . Reconcile ... general ledger and accounting assistance to financial staff. . Ensure compliance with accounting principles and procedures. . Recommend accounting process… more
- CVS Health (Trenton, NJ)
- …lifecycle management of Aetna's integrated products (HIDE/FIDE) that serve Medicare Advantage populations, including Dual-Eligible Special Needs Plans (D-SNP). This ... care objectives. Working cross-functionally with Duals Center of Excellence, clinical, compliance , analytics and network teams, the Senior Manager drives innovation… more
- Terumo Medical Corporation (Somerset, NJ)
- …the development and implementation of a monitoring and testing program, managing compliance with all Federal and State transparency reporting obligations, and ... divisional business functions to conduct and expand the Healthcare Compliance risk assessment. + Manages the Federal ...and a minimum of 10 years monitoring and transparency compliance experience in the medical device, healthcare… more
- Humana (Trenton, NJ)
- …clinical reference materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage ... authorized. All work occurs with a context of regulatory compliance , and work is assisted by diverse resources which...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- Humana (Trenton, NJ)
- …ensuring compliance with governmental requirements for clinics across both federal and state requirements. The work assignments involve moderately complex to ... and procedures. Research compliance issues and recommends changes that assure compliance with federal and/or state requirements related to Provider Clinic… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... clinical reference materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage… more
- Humana (Trenton, NJ)
- …determinations, clinical reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare ... clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed… more
- Humana (Trenton, NJ)
- …clinical reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicaid, and Medicare ... level. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
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