- Atlantic Health System (Morristown, NJ)
- …and legal research on regulatory issues, including fraud and abuse issues, HIPAA compliance , EMTALA, Medicare and Medicaid compliance , licensure issues, ... agreements, and home health and hospice agreements, assuring legal and regulatory compliance . Serve as a primary resource for the interpretation of contractual… more
- Molina Healthcare (New York, NY)
- …create and regularly reviews the reports and scorecards used to evaluate sales and compliance results in each state and nationally, as well as regularly spends time ... and production of the annual marketing strategy and objectives for Molina Medicare 's portfolio of Medicare products. + Responsible for supporting the… more
- Molina Healthcare (Grand Island, NE)
- **Job Description** **Job Summary** Leads and directs Molina Medicare segment leaders who are responsible for the development and administration of Medicare ... Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state, and local regulatory requirements. **Job… more
- AdventHealth (Tampa, FL)
- …and support as needed. **The value you'll bring to the team:** Performs Medicare compliance reviews and issues Advance Beneficiary Notices of Noncoverage as ... needed. Creates accurate estimates for patient financial responsibility and collects payments or establishes payment plans. Coordinates with utilization management staff for pre-authorization issues and ensures patients have necessary logistical information.… more
- AdventHealth (Lampasas, TX)
- …and support as needed. **The value you'll bring to the team:** Performs Medicare compliance reviews and issues Advance Beneficiary Notices of Noncoverage as ... needed. Creates accurate estimates for patient financial responsibility and collects payments or establishes payment plans. Coordinates with utilization management staff for pre-authorization issues and ensures patients have necessary logistical information.… more
- Sedgwick (Lexington, KY)
- …and laws + Knowledge of medical terminology for claim evaluation and Medicare compliance + Knowledge of appropriate application for deductibles, sub-limits, ... SIR's, carrier and large deductible programs. + Strong oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Strong organizational skills + Strong interpersonal skills + Good negotiation skills +… more
- HCA Healthcare (Conroe, TX)
- …American College of Cardiology, Society of Chest Pain Centers and governmental regulation for Medicare compliance . Manages all CV Data to include ACC, Action and ... STS data registries. **What you will do in this role:** + Develops and supports education to meet all requirements of Chest Pain Accreditation. + Develops and recommends protocol/guidelines for best practice of the cardiac patient across the continuum of care.… more
- Guidehouse (Pell City, AL)
- …orders for completion and ensures all required information is listed. + Completes Medicare Compliance and obtains ABN if necessary. + Knowledge of all ... Federal, State and Local Laws pertaining to insurance rules and regulations. + Utilizes multiple computer systems. + Maintains positive customer service at all times, referring unresolved issues to appropriate supervisor. + Answers telephone calls. Follows… more
- Guidehouse (Los Angeles, CA)
- …orders for completion and ensures all required information is listed. + Completes Medicare Compliance and obtains ABN if necessary. + Knowledge of all ... Federal, State and Local Laws pertaining to insurance rules and regulations. + Maintains multiple computer systems. + Maintains positive customer service at all times, referring unresolved issues to appropriate supervisor. + Answers telephone calls. Follows… more
- Guidehouse (Birmingham, AL)
- …orders for completion and ensures all required information is listed. + Completes Medicare Compliance and obtains ABN if necessary. + Knowledge of all ... Federal, State and Local Laws pertaining to insurance rules and regulations. + Utilizes multiple computer systems. + Maintains positive customer service at all times, referring unresolved issues to appropriate supervisor. + Answers telephone calls. Follows… more