- Humana (Harrisburg, PA)
- …comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root causes driving issues and developing solutions + ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Humana (Harrisburg, PA)
- …clearly-especially around generative AI. Design for scalability, reliability, and compliance . + **MLOps & DevOps Collaboration** Work with engineering and ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Banner Health (PA)
- …assurance for medical records. For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state ... Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG)...make needed corrections and ensure accurate coding, reimbursement, and compliance . 7. Provides mentoring for less experienced staff members… more
- St. Luke's University Health Network (Allentown, PA)
- …Services Auditor performs audits as part of the Documentation and Coding Compliance Program for professional services billed by providers employed with St. Luke's ... billing department. + Assisting with the development of training materials for compliance education and training modules. Provides training classes to new providers… more
- Aveanna Healthcare (Norristown, PA)
- …the right to remove HHA trainees from the Care Academy program for any compliance or policy violations or lack of or incomplete participation. Job Duties after HHA ... be required to demonstrate proficiency in clinical assessments, documentation and compliance with applicable care, policies and procedures. Requirements + High… more
- Humana (Harrisburg, PA)
- …scope, quality + In-depth knowledge of Medicaid regulations, policies, and compliance requirements. + Proven experience in managing cross-functional teams and ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- UPMC (Harrisburg, PA)
- …and provide ongoing education and communication to staff. Review to ensure 100% compliance with uLearn requirements is met. + Evaluates staff to ensure compliance ... make independent decisions. + Know insurance pre-certification/pre-authorization, Managed Care, Medicare /Medicaid and Commercial insurance plans. + Prior working experience… more
- Penn Medicine (Lancaster, PA)
- …and procedures for the retail pharmacies all locations . Ensures compliance with established departmental policies and procedures, State and Federal regulations ... with other areas of the sysem. + Ensures staff compliance with all policies and procedures, demonstrated by a...experience + A healthcare provider in good standing with Medicare , Medicaid, and other federal and state health insurance… more
- WellSpan Health (York, PA)
- …duties as identified. + WellSpan Health has adopted and implemented a compliance program to support WellSpan's values and standards for professionalism, integrity, ... organization and the performance expectations of the job, the department, and the compliance program. + WellSpan Health has adopted and implemented a privacy program… more
- Genesis Healthcare (Kennett Square, PA)
- …Lead, manage and develop staff to deliver positive business results. Assure compliance with policies and procedures. Develop new policies and maintain existing ... - Forecast. * Assure timely and complete submission of entries for Medicare Reimbursable Bad Debt (for Private) submission. * Develop alternative payment… more