- AmeriHealth Caritas (Lancaster, PA)
- …"CHC") and across the AmeriHealth Caritas organization (Pennsylvania Medicaid and Medicare plans, Pennsylvania shared services ( Compliance , Regulatory and ... and ensures activities are carried out within company, state, and CMS compliance rules and regulations. **Work Arrangement:** Remote with required travel in the… more
- Redeemer Health Home Care & Hospice (Meadowbrook, PA)
- …and Pathophysiology/Disease Processes/Pharmacology required. . Works claim edits identified along with compliance of the Medicare Coverage Determinations ( MCD ) ... ICD-10 and CPT-4 guidelines, UHDDS sequencing guidelines, CMS coding guidelines, Medicare and Medicaid regulations and the American Hospital Association coding… more
- Prime Therapeutics (Harrisburg, PA)
- …fuels our passion and drives every decision we make. **Job Posting Title** Compliance Analyst Principal - Remote **Job Description** The Compliance Principal is ... execution of the Regulatory Intelligence communication strategy. This position acts as Compliance and regulatory liaison for all lines of business with internal… more
- Prime Therapeutics (Harrisburg, PA)
- …fuels our passion and drives every decision we make. **Job Posting Title** Compliance Analyst Principal (Performance and Oversight) - Remote **Job Description** The ... Compliance Principal is responsible for supporting Oversight and Monitoring...or within a highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) +… more
- University of Pennsylvania (Philadelphia, PA)
- …rates. + Work with the Unit Manager to conduct monitoring of research finance compliance with the Medicare Clinical Trial Policy, including review of key ... and supplemental industry-sponsored clinical research proposals in Penn-ERA to ensure compliance with PSOM overhead policy. + Process Research Billing Numbers,… more
- Humana (Harrisburg, PA)
- …of our caring community and help us put health first** The Senior Compliance Professional ensures compliance with governmental requirements. The Senior ... situations or data requires an in-depth evaluation of variable factors. **Regulatory Compliance - State Enterprise Intake and Implementation - Senior Compliance … more
- Philips (Malvern, PA)
- As the **Business Compliance Officer** , you will oversee the Company's obligations under a Corporate Integrity Agreement (CIA) and provide compliance guidance ... responsible for the overall performance, operation, and success of Philips BioTel AM&D's compliance program, using the seven elements of an effective compliance … more
- Guthrie (Sayre, PA)
- Summary: A senior level compliance coding auditor conducting assessments in accordance with The Guthrie Clinic's policies and procedures and accepted guidelines for ... medical coding. Works closely with the Compliance Officer and Compliance coding Audit Coordinator...as well as The Guthrie Clinic policies, as applicable, Medicare , Medicaid, and LCD (Local Coverage Determinations), and NCD… more
- Baylor Scott & White Health (Harrisburg, PA)
- …lessons are completed in a timely way. . Responds to inquiries utilizing applicable Medicare and Medicaid guidance. Serves as a compliance resource to BSWH ... JOB SUMMARY The Third Party Compliance Consultant Sr performs ongoing activities related to...of, and adherence to established policies and procedures in compliance with federal, state, and local laws and regulations.… more
- Cardinal Health (Harrisburg, PA)
- **_What Ethics & Compliance contributes to Cardinal Health_** Ethics & Compliance promotes a culture that encourages ethical conduct and a commitment to ... compliance . This function implements strategies and processes to ensure...facility fee coding and auditing. + Expert-level knowledge of Medicare and Medicaid documentation and coding rules and guidelines;… more