- Atlantic Health System (Morristown, NJ)
- …and legal research on regulatory issues, including fraud and abuse issues, HIPAA compliance , EMTALA, Medicare and Medicaid compliance , licensure issues, ... care. Develops, with our physician colleagues, a system-wide quality review program. Ensures compliance with local, state, federal rules and regulations and OSHA… more
- Fresenius Medical Center (Belleville, NJ)
- …**Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans** ... accordance with FMCNA policies procedures and training and in compliance with regulations set forth by the corporation state...with regulations set forth by the corporation state and federal agencies. Responsible for the setup and operation of… more
- Humana (Trenton, NJ)
- …the core of this evolution is Humana's Insurance Segment, which provides Medicare Advantage, Medicaid, and other health plans to millions. By integrating insurance ... a pivotal role in defining the future of Humana's Medicare and Medicaid businesses, which generate the majority of...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Humana (Trenton, NJ)
- …in determining objectives and approaches to assignments. The role is within the Medicare Finance organization. This role will be required to collaborate with various ... requests and perform valuations that help inform financial strategy related to the Medicare Advantage line of business. **Use your skills to make an impact**… more
- Sunrise Senior Living (Edison, NJ)
- …Living, "to champion the quality of life for all seniors" in accordance with federal , state and local standards and Sunrise Senior Living policies to promote the ... follows Resident Centered Care model. + Assists with case management of both Medicare and non- Medicare guests/residents as needed. + Participates in the Care… more
- St. George Tanaq Corporation (Trenton, NJ)
- …and Skills** + One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related ... evidence, regulations, policies, and procedures + Conducts research using online federal regulations, contract policy, standards of medical practice, contract… more
- CVS Health (Trenton, NJ)
- …setting. + Sound knowledge of coding guidelines and regulations to meet compliance requirements, such as establishing medical necessity. + Identify clinically ... Summary** + Responsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit...ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of… more
- Humana (Trenton, NJ)
- …analytics expertise, and a proven track record of leveraging data to meet compliance requirements and define and drive business value. The Senior Professional will ... analyze, synthesize, and present data related to benefit utilization, ensuring compliance with state reporting requirements and providing a comprehensive view of… more
- Intermountain Health (Trenton, NJ)
- …of value-based care by Intermountain Healthcare to appropriate populations. It ensures compliance and accurate submission of publicly reported data for all payers. ... with ICD-10-CM and Official Coding Guidelines as determined by Centers for Medicare and Medicaid Services (CMS), National Center for Health Statistics (NCHS), US… more
- RWJBarnabas Health (Somerville, NJ)
- …in compliance with hospital Red Flag Policy. + Completes Medicare Questionnaire on all patients that are eligible. Obtains required legal signatures ... consent. + Demonstrates the ability to understand and explain federal and state regulations including but not limited to... and state regulations including but not limited to Medicare Secondary Payer regulations for Medicare eligible… more