- Highmark Health (Pittsburgh, PA)
- …for risk revenue management for all government program products (commercial ACA, Medicare , and Medicaid). Establishes the strategic direction for the Risk Revenue ... Management governance strategy for the Enterprise to appropriately manage CMS audit risk. **ESSENTIAL RESPONSIBILITIES:** 1. Program Development and Management: +… more
- Ventura County (Ventura, CA)
- …for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare , and general insurance reimbursement requirements. The ideal candidate possesses ... medical billing or a related field. + Experience in Managed Care/Medicaid/ Medicare and/or Commercial Insurance billing. + Experience with multiple Electronic Health… more
- UCLA Health (Los Angeles, CA)
- …lead the preparation and review of financial and statistical information for Medicare and Medi-Cal cost reports. You will collaborate across departments to ensure ... compliance, optimize reimbursement, and support audit processes. You will: + Prepare, review, and analyze...Prepare, review, and analyze financial and statistical data for Medicare and Medi-Cal cost reports. + Serve as the… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …protocols which align with Bon Secours Mercy Health's overall compliance audit and compliance responsibilities relative to hospital revenue cycle services performed ... procedures for the development of compliance internal monitors and audit protocols and the prevention of fraud, waste and...hospital revenue cycle risk areas highlighted by the OIG, Medicare , State Medicaid, State Insurance Fraud; Managed Care or… more
- Centene Corporation (Austin, TX)
- …Supports Senior Specialists and Managers with implementation of approved language updates and audit of such changes in Medicare materials. + Develops errata ... workplace flexibility. **Position Purpose:** Responsible for development and production of Medicare regulatory required materials to ensure compliance with State and… more
- University of Rochester (Rochester, NY)
- …Physician Self-Referral Law, the False Claims Act, Civil Monetary Penalties, and Medicare and Medicaid billing regulations (including CMS, Medicare Advantage and ... Compliance on relevant reimbursement and billing issues and requirements (including CMS, Medicare Advantage, and New York State Medicaid). Stays abreast of … more
- Trinity Health (Columbus, OH)
- …A thorough understanding of NCQA and HEDIS is required. Knowledge of Medicare Stars-including CAHPS, HOS, Part D, and operational measures-is strongly preferred. ... **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across… more
- Avera (Fargo, ND)
- …eligible for relocation assistance. Seeking a candidate with 5+ years of Medicare Cost Reporting experience. Avera offers ccompetitive salary and benefits! **You ... will be responsible for the oversight of reimbursement associated with the Medicare , Medicaid, Tricare and any other governmental cost reports and regulatory support… more
- Beth Israel Lahey Health (Charlestown, MA)
- …deep knowledge of both government and commercial payment systems; and, (4) Provide Medicare , Medicaid, and payment system expertise in support of BILH provider and ... VP and AVP, the Director will develop long- and short- term Medicare , Medicaid, and other government reimbursement revenue strategies, oversee preparation and… more
- CareOregon (Portland, OR)
- …Level n/a Direct Reports n/a Manager Title Delegation Oversight Manager Department Audit and Compliance Pay and Benefits Estimated hiring range $31.44/ hr - ... regulatory requirements. | Develop, revise, and maintain all delegation audit tools and written agreements as necessary to comply...with Oregon Health plan (OHP) and the Centers for Medicare and Medicaid Services (CMS) | Bachelor's degree (or… more