- Humana (Harrisburg, PA)
- …Adhere to established guidelines and procedures to ensure consistency and compliance . **Potential Duties** + Advocate for our agile development approach and ... leadership and consulting. + Knowledge of healthcare business domains, including Medicare , Medicaid, Group, Specialty, etc. + Development level knowledge utilizing… more
- Penn Medicine (Lancaster, PA)
- …charging and delivery of medication to patient care areas, in compliance with department policies and procedures that provide optimal pharmaceutical care. ... the following duties: + Demonstrates a thorough understanding of and compliance with procedures for handling controlled substances and specialty pharmaceuticals… more
- UPMC (Lancaster, PA)
- …individuals with physical disabilities in the Commonwealth who are covered by Medicare and Medicaid. To provide service coordination services across the continuum of ... that OPS reporting is completed per regulatory deadline and compliance requirements. + Responsible for performing profession-level administrative duties involving… more
- Banner Health (PA)
- …knowledge of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group (APR-DRG) and Ambulatory Payment ... ensure that clinical coding is accurate for proper reimbursement and that coding compliance is complete. Provides feedback on coding work and trends, and offers… more
- Evolent (Harrisburg, PA)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...part of the application process. This is collected for compliance and security purposes and only reviewed if an… more
- Surgery Care Affiliates (Philadelphia, PA)
- …+ The Insurance Verifier will call each patient as part of center compliance with CMS Conditions for Coverage guidelines in contacting patient's prior to the ... payable, notify patient. If patient wants to proceed, obtain signature on Medicare ABN or other non-covered notification form. Financial Orientation: + Calculate… more
- UPMC (Pittsburgh, PA)
- …for Medical Assistance! Additionally, CHC is also for individuals that qualify for Medicare , Medicaid, or require a nursing facility level of care. The CHC Service ... to OPS reporting completed per regulatory deadline and that compliance requirements. + Responsible for performing profession-level administrative duties involving… more
- Option Care Health (Audubon, PA)
- …is maintained by providing direct patient care 20-40% of the time. In a Medicare Certified Home Health agency, this position may also serve as the alternate ... Director of Nursing of the Home Health Agency for Medicare certified home health agencies in the absence of...operations and communications and ensures the office remains in compliance with all regulating and accreditation entities. Complies with… more
- Evolent (Harrisburg, PA)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...part of the application process. This is collected for compliance and security purposes and only reviewed if an… more
- Evolent (Harrisburg, PA)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...part of the application process. This is collected for compliance and security purposes and only reviewed if an… more