- Outreach Development Corporation (Richmond Hill, NY)
- …protect the organization's financial well-being. Compliance + Ensure compliance with financial reporting requirements, regulatory standards, tax reporting, ... + Ensuring that all patient services are accurately coded and billed in compliance with healthcare regulations, and payer requirements (eg, Medicare, Medicaid, … more
- Trinity Health (Silver Spring, MD)
- …a critical role in optimizing patient care delivery, resource utilization, and compliance with regulatory standards while upholding the mission, vision, and ... + Manage and lead daily operations to meet organizational goals and ensure compliance with regulatory and accreditation standards. + Oversee the recruitment,… more
- Highmark Health (Harrisburg, PA)
- …evaluation of outcomes and activities necessary to facilitate member access to healthcare services. Advocates for the most appropriate care plan using sound clinical ... with internal and/or external customers and contacts. Follows established regulatory guidelines, policies, and procedures in relation to member interventions… more
- Trinity Health (Livonia, MI)
- …RHIT, CCS, CPC / COC or other coding credentials strongly preferred. CDC ( Healthcare Compliance Certification) and CHRI (Certificate in Healthcare Revenue ... Management, Ancillary, Nursing, Patient Business Service (PBS) center, Information Services, Compliance & Managed Care department staffs. Audits Charge Master… more
- University of Colorado (Aurora, CO)
- …Understanding of payment reform, Medicare, Medicaid, private insurance regulations, and healthcare operations. + Regulatory Compliance : Expertise in ... financial policies and procedures and ensure their consistent implementation and compliance with university, college, state, and federal requirements. + Serves as… more
- Fairview Health Services (Minneapolis, MN)
- …including credential vaulting, Just-in-Time (JIT) access, and session auditing. + Ensure compliance with regulatory standards (eg, GDPR, SOX, HIPAA, NIST, ISO ... into business impact for Senior leadership/audit committees. + Strong knowledge of compliance and regulatory requirements impacting security, such as HIPAA,… more
- Banner Health (Scottsdale, AZ)
- …are involved in the provision of needed health care services. 8. Assures compliance with all regulatory bodies, including Medicare, State, Joint Commission and ... Uses creativity in the delivery of services and products in a highly competitive managed care market. Ensures that planning within the departments is done in a… more
- Integra Partners (Troy, MI)
- …escalating issues as needed to the UM Clinical Manager. + Ensure compliance with all regulatory , contractual, and accreditation standards (CMS, NCQA, ... by conducting regular 1:1s, managing performance reviews, and driving compliance with organizational, state, and federal requirements. The Supervisor balances… more
- Devereux Advanced Behavioral Health (Orlando, FL)
- … Managed Care Plans, and third-party payer systems + Familiarity with regulatory and compliance requirements + Understanding of Local and Federal billing ... for data analysis. + Ensure accurate billing and claims submission for Medicaid, Managed Care, and other third-party payors + Hiring and training staff. + Managing… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ensuring compliance with internal and external ... metrics and meeting requirements established for audits to ensure adherence to regulatory and departmental policy/procedures. + Maintains compliance with all … more