- Prime Therapeutics (Harrisburg, PA)
- …our passion and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior ... Compliance Analyst assists in the implementation of Prime's ...organization, or other highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) +… more
- Highmark Health (Harrisburg, PA)
- …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
- Baylor Scott & White Health (Harrisburg, PA)
- JOB SUMMARY The Healthcare Billing Compliance Consultant Sr performs ongoing activities related to the development, implementation, maintenance of, and adherence to ... established policies and procedures in compliance with federal, state, and local laws and regulations..... Responds to inquiries and guidance requests utilizing applicable Medicare and Medicaid rules and regulations. Serves as a… more
- WellSpan Health (York, PA)
- …laws, hospital/physician issues, complex contract negotiation and management, Medicare /Medicaid reimbursement issues, regulatory compliance , patient issues, ... employment law, contract law, nonprofit corporate governance, tax and medical staff issues. + Maintains professional affiliations and enhances professional growth and development to keep abreast of latest trends in field of expertise. + Provides outstanding… more
- Penn Medicine (Bala Cynwyd, PA)
- …you living your life's work? Entity: Corporate Services Department: Office of Billing Compliance Hours: M-F, 8 hr days, hybrid Location: 150 Monument Road, Bala ... Cynwyd, PA Summary: + The Compliance Analyst (CA) I is responsible for audits, reviews,...the changes in the CPT coding, CMS regulations, local Medicare carrier (Novitas) in order to provide the most… more
- Humana (Harrisburg, PA)
- …help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare ... the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. All work occurs… more
- Fresenius Medical Center (Carlisle, PA)
- …core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and company policy requirements PRINCIPAL ... options: + Educates on the availability of alternative insurance options (ie, Medicare , Medicaid, Medicare Supplement, State Renal programs and COBRA). +… more
- Humana (Harrisburg, PA)
- …service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national ... internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to… more
- Humana (Harrisburg, PA)
- …customers at the center of everything it does. Are you passionate about the Medicare population, looking for a role in management with the ability to directly impact ... self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of ...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Humana (Harrisburg, PA)
- …service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national ... teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicare Advantage, and Medicaid requirements and will understand… more