- Atlantic Health System (Morristown, NJ)
- …issues, including fraud and abuse issues, HIPAA compliance, EMTALA, Medicare and Medicaid compliance, licensure issues, pay-to-play issues, corporate governance ... regulatory and corporate work experience, including prior experience with hospitals, Medicare and Medicaid, and federal and state healthcare regulatory issues,… more
- Hackensack Meridian Health (Edison, NJ)
- …audits for medical provider documentation while adhering to Centers for Medicare and Medicaid Services (CMS) and Office of Inspector General (OIG) guidelines for ... skills. + High-level understanding of coding and auditing concepts, American Medical Association (AMA)/Centers for Medicare and Medicaid Services (CMS)/Office… more
- Cardinal Health (Trenton, NJ)
- …and proactively provides guidance and trainings on policies. Reporting to the Director , Ethics & Compliance, this position supervises and manages audits to determine ... detection and correction of documentation, coding, and billing errors and/or medical necessity of services billed. Particular areas of focus include: evaluation… more
- Atlantic Health System (Newton, NJ)
- …and adherence with corrective action plans and reports findings to the Director of Quality and Patient Safety or designee. 4. Regulatory Compliance: Participates ... such Joint Commission, State Department of Health, Centers for Medicare and Medicaid, payers and other agencies. Provides support...Our facilities and sites of care include: + Morristown Medical Center, Morristown, NJ + Overlook Medical … more
- Humana (Trenton, NJ)
- …mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance, by ensuring compliance with governmental requirements for ... experience in revenue cycle management (related to billing, coding, collections for Medicare and Medicaid claims) + Experience with Auditing and monitoring of… more
- Nestle (Bridgewater, NJ)
- …distributor partnerships. Collaborating with National Account Senior Managers and the Director of the Distributor Channel, the Senior Manager develops and implements ... market dynamics, including reimbursement models and payer landscapes (Medicaid, Medicare , and private insurance). By negotiating and executing distributor programs,… more
- WTW (Fort Lee, NJ)
- …leading direct-to-consumer insurance services business, specializing in the distribution of Medicare Advantage, Medicare Supplement and Life & Supplemental ... our success. As a performance-driven CTV media buyer, you will report to the Senior Director of Media and be responsible for all aspects of our CTV media campaigns… more
- Serenity Hospice Care (Atlantic County, NJ)
- …a collaborating physician. + Consults with the patient's attending physician, the medical director and other healthcare practitioners regarding the patient's ... total needs of patients and family/caregiver + Makes recommendations to the Medical Director regarding patient eligibility for certification and recertification… more
- Ascendis Pharma (Princeton, NJ)
- …mission of developing new and potentially best-in-class therapies to address unmet medical needs. Our culture fosters a place where skilled, adaptable, and highly ... NJ three (3) days/week and will report directly to the Director , Contracting Operations. Requirements Key Responsibilities: Rebate Management . Administer and… more
- Sunrise Senior Living (Edison, NJ)
- …Care Plan process and required documentation. + Facilitate the Triple Check and Medicare meetings weekly. + Ensure billing information is available for the Business ... and completeness. + Ensure Individualized Care Plans meet the guest/resident's medical , nursing, and psychosocial needs as identified in the guest/resident… more