- East Boston Neighborhood Health Center (Revere, MA)
- …organization-including primary care, behavioral health, specialties, PACE, pharmacy/340B, grants management , and administrative functions. The CFO is responsible for ... of systems, controls, and processes that meet Federal, State, HRSA, CMS , and hospital-licensed health center (HLHC) requirements. This role oversees Accounting,… more
- CareFirst (Baltimore, MD)
- …& Qualifications** **PURPOSE:** The role of the Nurse, Quality Review Utilization Management (UM) is to evaluate clinical quality and procedures within the ... Utilization Management (UM) program to maximize efficiency, ensure compliance and...and Abilities (KSAs)** + Strong understanding of NCQA standards, CMS regulations, and state/federal compliance requirements. + Strong understanding… more
- St Croix Hospice (Mendota Heights, MN)
- …comprehensive compliance audit program tailored to meet the requirements of CMS , Medicaid, Medicare, Medicare Advantage plans, other government payors, private ... action recommendations. + Assist with the establishment of a continuous monitoring system for compliance risks and policy effectiveness. + Risk Assessment, Audits… more
- Dartmouth Health (Lebanon, NH)
- …Laboratory services to DHMC and Clinics physician practices, Dartmouth Health system member hospitals, and independent practices and hospitals throughout NH and ... Canada or an accredited laboratory* within the last five years. * CMS CLIA certificate of registration, compliance, accreditation; OR JCI accreditation; OR… more
- Virgin Galactic (Tustin, CA)
- …ideal candidate brings deep experience building B2C digital solutions, managing complex system integrations (Salesforce, payments, CMS ), and working with luxury ... secure, and high-quality delivery. + Own the end-to-end technical architecture, system design, and platform integrations across Salesforce, payment systems, CMS… more
- Providence (Los Angeles County, CA)
- …of unit services in accordance with current Center for Medicare/Medicaid Services ( CMS ) guidelines and regulations. Under the direction of the Medical Director the ... and external referrals for admission per the criteria established by CMS and coordinates and facilitates admission including obtaining of insurance authorization… more
- UCLA Health (Los Angeles, CA)
- …and resolve charge capture issues, ensuring accuracy, timeliness, and compliance with CMS , AMA, and internal guidelines + Collaborate with clinical and operational ... leadership on compliance risks and revenue opportunities + Contribute to system enhancements, workflow redesigns, and strategic initiatives to optimize reimbursement… more
- Point32Health (Boston, MA)
- …questions. We have extensive experience in curating and using electronic health system data including health insurance claims, medical records, and surveys. HPI ... in collaboration with other academic institutions and state and health system partners. The post-doctoral fellow will also participate in the Health… more
- Atlantic Health System (Morristown, NJ)
- …and accurate code assignments in accordance with Center of Medicare and Medicaid ( CMS ) guidelines and provide ongoing feedback and analysis of the education needs ... from medical records according to ICD-10, CPT, HCPCS, and CMS guidelines + Responsible for maintaining up to date...and Coding and billing experience #LI-AW1 At Atlantic Health System , our promise to our communities is; Anyone who… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …coding and documentation based on audit findings and as required by current CMS regulations. Work directly with the Medical Coding Auditor Manager to implement best ... + Ensure compliance with federal, state, and payer-specific regulations, including CMS guidelines + Identify and address coding discrepancies and recommend… more
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