- WellLife Network (Smithtown, NY)
- …denials, and payment delays. + Monitor staff documentation practices to ensure compliance with Medicaid, Medicare , and private insurance billing requirements. + ... staff productivity, stabilizing program finances, growing service capacity, and ensuring compliance with all regulatory and licensing bodies, including the NYS… more
- CVS Health (Albany, NY)
- …part in ensuring coding accuracy and data integrity, directly impacting compliance and financial performance. Ideal candidates will bring a strong understanding ... continuous improvement. This position will sit within our Regulatory Compliance team and offers the flexibility of working from...ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of… more
- Humana (Albany, NY)
- …about 340+ senior focused primary care centers in 15 states. The Regulatory Compliance team that supports the PCO is responsibility to assess, investigate, audit and ... validate the mitigation of compliance risk across the organization. This team ensures that...revenue cycle management (related to billing, coding, collections for Medicare and Medicaid claims) + Experience with Auditing and… more
- NASCO (Albany, NY)
- **Overview** The Senior Corporate Counsel, Compliance & Commercial operates under general direction and is responsible for providing legal and regulatory guidance to ... and drafts complex commercial transactions, including technology agreements, and provides compliance guidance and support throughout the organization to ensure our… more
- MVP Health Care (Schenectady, NY)
- …and State Anti-Fraud investigation and reporting requirements including HIPAA, CMS, Medicare , Medicaid, and any corporate compliance initiatives or policies. ... you have a passion for problem solving and investigations, commitment to compliance and ethical standards and dedication to continuous learning and improvement.… more
- Humana (Albany, NY)
- …team. **Preferred Qualifications:** + Master's Degree + Knowledge of the Medicare Advantage market, products, regulations, and compliance standards **Additional ... the health care or insurance industry, and specifically in Medicare Advantage products + Exceptional leadership and management skills,...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Mount Sinai Health System (New York, NY)
- …and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's subject ... across the Mount Sinai Health System. MSHP seeks a Senior Contract Compliance (Hospital Billing) Analyst who will primarily be responsible for tracking, trending,… more
- YAI (Manhattan, NY)
- …Key/Essential Functions & Responsibilities + Implements the organization's compliance program under the supervision of the Assistant Director ... of Corporate Compliance and in coordination with program staff. + Maintains...(Office for People with Developmental Disabilities (OPWDD), Centers for Medicare and Medicaid Services (CMS), Office of Medicaid Inspector… more
- Highmark Health (Albany, NY)
- …This job is responsible for planning, designing, implementing, and maintaining the Compliance Program and its related policies to ensure the business acts within ... responsible for the administration, interpretation, and enforcement of the Compliance Program including auditing/monitoring operational processes, conducting or overseeing… more
- Molina Healthcare (NY)
- **JOB DESCRIPTION** **Job Summary** Molina Healthcare's Compliance team supports compliance operations for all Molina product lines enterprise wide. It is a ... centralized corporate function supporting compliance activities at individual state...+ Performs Plan Required Reporting. + Interpret and analyzes Medicare , Medicaid and MMP Required Reporting Technical Specifications. +… more