- AdventHealth (Altamonte Springs, FL)
- …to provide feedback to CDI Market Leaders + Performs quality reviews of the medical record for compliance including completeness and accuracy for severity of ... allied health practitioners, nursing, and care management. This includes quarterly compliance updates from Medicare . + Effectively and appropriately communicates… more
- WestCare Foundation (Henderson, NV)
- …expertise in the areas of quality documentation and records review in relation to Medicaid/ Medicare regulations and all other federal , state and local rules and ... Contract Compliance Assistant Job Details Job Location Henderson -...the agency in ensuring that documentation requirements for Medicaid, Medicare and other funding sources per chapter and contract… more
- Waystar (Lehi, UT)
- **ABOUT THIS POSITION** The Regulatory and Legal Compliance Counsel will assist the Associate GC & Privacy Officer with drafting, implementing, and overseeing the ... organization's global privacy, regulatory, and legal compliance programs. This individual ensures adherence to applicable laws...programs in accordance with changes in laws. + Monitor federal and state regulatory changes, industry trends and best… more
- Humana (Frankfort, KY)
- …a part of our caring community and help us put health first** The Compliance Professional 2 ensures compliance with governmental requirements. The Compliance ... interpretation and independent determination of the appropriate courses of action. The Compliance Professional 2 develops and implements compliance policies and… more
- University of Utah (Salt Lake City, UT)
- …and reviews UBs and 1500s against provider and facility documentation to ensure compliance with University, state and federal guidelines. 3. Reconciles clinic or ... Details **Open Date** 05/13/2025 **Requisition Number** PRN41889B **Job Title** Compliance Specialist **Working Title** Compliance Specialist **Job Grade** E… more
- Providence (WA)
- … matters in one or more of the following lines of business: Medicare , Medicaid, Commercial + Experience assessing program compliance and establishing auditing ... them._** **Providence Health Plan is calling an Audit and Compliance Analyst who will:** + Handle various elements of...& Government Affairs department (RCGA) to evaluate state and federal regulations as they apply to Health Care Services… more
- Humana (Tallahassee, FL)
- …and help us put health first** Humana Healthy Horizons is seeking a Senior Compliance Professional to ensure compliance as they relate to Medicaid State ... reporting. The Senior Compliance Professional work assignments involve moderately complex to complex...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Humana (Boise, ID)
- …caring community and help us put health first** The Risk Adjustment Compliance Professional 2 supports the organization's adherence to governmental and contractual ... in determining appropriate actions within established framework. The Risk Adjustment Compliance Professional 2 contributes to the execution of the organization's… more
- Signature Healthcare (Memphis, TN)
- …facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified Great ... with Purpose at Signature HealthCARE! + Ensure that a company-wide regulatory compliance program is ongoing in accordance with company policies, standards of… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Payment Compliance Billing Specialist I is responsible for processing, auditing, and submitting primary and secondary insurance claims, ensuring ... accuracy, compliance , and timely reimbursement. This role utilizes electronic claims...payers to ensure clean claim submission and adherence to federal , state, and payer-specific regulations. **Essential Functions** + Processes… more