- CVS Health (Woonsocket, RI)
- …regulations, including HIPAA, Medicare , Medicaid, the False Claims Act, and the Federal Anti-Kickback Statute + You have a commitment to high standards in your ... including HIPAA, Medicare , Medicaid, the False Claims Act, and the Federal Anti-Kickback Statute + Experiences with PBMs + You have expertise in negotiating… more
- Kelsey-Seybold Clinic (Webster, TX)
- …and to improve the efficiency and effectiveness of resources + Ensure compliance with legal, regulatory, and clinical policies and procedures **Essential Duties and ... and is in-network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with… more
- State of Michigan (MI)
- …surveys. The purpose of these surveys is to determine initial and ongoing compliance of federal certified providers with applicable portions of the Code ... and certification activities on behalf of the Centers for Medicare and Medicaid Services (CMS). The health care surveyor...of Federal Regulations (CFR) and may be conducted by an… more
- Silicon Valley Power (Santa Clara, CA)
- …Engineering Technician, who assigns tasks and reviews work to ensure compliance with instructions and established engineering standards. Below is a briefing ... capital improvement program. The division also coordinates with the Federal Emergency Management Agency on the City's Community Rating...formula - employee pays 7.00% of gross pay + Medicare and Social Security (FICA) + Employee pays 6.20%… more
- Kelsey-Seybold Clinic (Shenandoah, TX)
- …providers to assist in the management of psychosocial problems interfering with compliance and other treatment regimens. The therapist will conduct evaluations and ... and is in-network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with… more
- The County of Los Angeles (Los Angeles, CA)
- …with Professional Standards Review Organization representative to orient new staff to Federal laws and regulations pertaining to Medicare and Medi-Cal ... criteria, and for certification of approved hospital days reimbursable under the Medicare and MediCal programs. Essential Job Functions + Plans, develops, and… more
- Humana (Topeka, KS)
- …with members while concurrently navigating multiple computer applications. To ensure compliance and support the auto dialer process essential to our business, ... communication and interpersonal skills. **Duties Include** + Telephonically work with Medicare members with transitional needs and complex chronic conditions. +… more
- Option Care Health (Nashville, TN)
- …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 ... Patient management skills, the Nursing Process, the rules of Federal , state, and local regulatory entities that oversee and...Director of Nursing of the Home Health Agency for Medicare certified home health agencies in the absence of… more
- University of Michigan (Ann Arbor, MI)
- …highly motivated Senior Billing Clerk/Patient Account Representative to join our Medicare Advantage Hospital Billing Team. Responsible for accurate claim submission, ... discrepancies and take appropriate corrective action when necessary ensuring compliance + Move payments to accounts ensuring appropriate payment category,… more
- Ventura County (Ventura, CA)
- …& appropriate resource use; + Recommends alternative levels of care & ensures compliance with federal , state & local requirements; + Assesses high-risk patients ... Premium Pay - 1/4 of regular hourly wage or Federal minimum wage (whichever is greater) + Flexible Credit...to internal & external regulatory & accreditation requirements & compliance guidelines, including but not limited to: The Joint… more