- Ventura County (Ventura, CA)
- …State Controller's Manual, Governmental Accounting, Auditing and Financial Reporting, and Federal Office of Management and Budget (OMB) guidelines; + Evaluates ... payable processes. Evaluates and reviews accounting policies and systems for compliance with regulations and reporting requirements; and + Performs other related… more
- University of Rochester (Rochester, NY)
- …to authorizations, coordination of benefits, baby not on policy, Cobra entitlement, Medicare Lifetime Reserve days, and Medicare Advantage issues. This role ... adding newborns onto policy. + Determine the primary payer through knowledge of Medicare and other payer regulations for the coordination of benefits. + Notify… more
- CVS Health (Tallahassee, FL)
- …do it all with heart, each and every day. **Pharmacy Technician, Aetna Medicare - Work From Home** **(Aetna Medicare Pharmacy Technician)** **BUSINESS ... Advantage members' adherence to select maintenance medications informs health plans' Medicare Stars quality rating and may lead to better health outcomes.… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …timely, and complete clinical quality reporting across multiple programs including Medicare CQMs, HEDIS, Stars, and Commercial payer quality initiatives. This role ... documentation in structured data fields within their EMRs to meet Medicare and Commercial payer quality reporting requirements. + Facilitates the generation,… more
- Highmark Health (Camp Hill, PA)
- …budgetary responsibility and authority. + As a seasoned Group Retiree market expert ( Medicare Advantage, Medicare Supplement, Part D, Medicare Exchanges) ... and maintain knowledge of the Commercial, Group Retiree and Medicare markets and competition. + Develop strategies and tactics...includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well… more
- CareOregon (Portland, OR)
- …medical interventions as delegated by registered nurse/clinician. + Perform duties in compliance with Medicare Condition of Participation. + Responsible for ... in position Knowledge, Skills and Abilities Required Knowledge + Knowledge of Federal , State and Local regulations, Hospice Medicare Conditions of Participation,… more
- Humana (Miami, FL)
- …Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to help ... people with Medicare , or both Medicare and Medicaid, achieve...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Northwell Health (Westbury, NY)
- …Medicare /non- Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. + Applies coding rules and ... to the validation review process. + Reviews codes on Medicare /non- Medicare charts for compliance to...changes necessary to provide the most valid documentation in compliance with Federal and State regulations. +… more
- Humana (Raleigh, NC)
- …the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Begins to ... and authorship. Exercises independence in meeting departmental expectations, and meets compliance timelines. **Required Qualifications** + MD or DO degree + 5+… more
- Northwell Health (Westbury, NY)
- …/non- Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. 5.Applies coding rules and regulations ... to the validation review process. 6.Reviews codes on Medicare /non- Medicare charts for compliance to...changes necessary to provide the most valid documentation in compliance with Federal and State regulations. 9.Operates… more