- Trinity Health (Livonia, MI)
- …payments & ensures that patients meet financial requirements including Medicare medical necessity, payer pre-certifications & referrals. Provides general information ... ROI & impacts. **Maintains a Working Knowledge** of applicable federal , state & local laws / regulations, Trinity Health...& local laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as… more
- Michigan State University (East Lansing, MI)
- …pending for trial. (10%) + Responsible for governmental reporting including MSU, State and Federal offices such as Medicare and OSHA. (10%) + Works with ... reports. (5%) + Assist employees via examining medical records for compliance with LTD, process, eligibility laws, and guidelines. Maintains appropriate… more
- CVS Health (Oklahoma City, OK)
- …Health's internal inpatient platform. + Adhere to CMS, state specific and NCQA compliance criteria as related to Transitions of Care. + Evaluate patient status ... Qualifications** + Experience in utilization management + Knowledge of Medicare /Medicaid and NCQA regulatory transitions of care criteria +...will be considered for employment in accordance with all federal , state and local laws. We are an equal… more
- Marshfield Clinic (Marshfield, WI)
- …501(c)(3) organization. This may qualify you for additional state and/or federal education loan forgiveness programs._ MCHS strongly encourages our physicians to ... the needs of patients and customers first.** **Exclusion From Federal Programs: Employee may not at any time have...excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment.… more
- Marshfield Clinic (Eau Claire, WI)
- …501(c)(3) organization. This may qualify you for additional state and/or federal education loan forgiveness programs._ MCHS strongly encourages our physicians to ... the needs of patients and customers first.** **Exclusion From Federal Programs: Employee may not at any time have...excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment.… more
- Cardinal Health (Richmond, VA)
- …billing, coding, posting and front office teams to resolve account issues + Ensure compliance with HIPAA and all relevant federal /state payor regulations. + Flag ... insurance claim processing and denial management preferred. + Familiarity with Medicare , Medicaid, commercial insurance plans, and managed care preferred. +… more
- Cardinal Health (Nashville, TN)
- …knowledge of payer policies, coding changes, and reimbursement guidelines. + Ensure compliance with HIPAA and all relevant federal /state billing regulations. + ... insurance claim processing and denial management preferred. + Familiarity with Medicare , Medicaid, commercial insurance plans, and managed care preferred. +… more
- AdventHealth (Calhoun, GA)
- …GA **Top Reasons To Work At AdventHealth Gordon** Four-star Rating, Centers for Medicare & Medicaid Services 150 Great places to work in Healthcare, _Beckers ... departmental standards. Responsibility to adhere to the Hospital Corporate compliance plan, to the rules and regulations of all...the rules and regulations of all local, state, and Federal agencies, and to the standards of all accrediting… more
- UnityPoint Health (Des Moines, IA)
- …patient safety through appropriate identification, maximum reimbursement for hospital charges and compliance with all state and federal regulations. Interacts in ... these regulations. * Remains aware of state (IA) and federal laws in regards to registration processes. * Ensures...patients of need for Advanced Beneficiary Notice (ABN) for Medicare . * Documents on accounts using hospital account note… more
- CVS Health (Columbus, OH)
- …to maintain and enhance provider networks while meeting and exceeding accessibility, compliance , quality, and financial goals and cost incentives + Manages contract ... HMO, PPO products knowledge + 3-5 years related experience Medicare and/or Medicaid products knowledge + Knowledge of Kentucky/Ohio...will be considered for employment in accordance with all federal , state and local laws. We are an equal… more