- HonorHealth (AZ)
- …appropriate for billing, internal and external reporting, research, and regulatory compliance . Codes complex accounts which requires advanced expertise in coding ... documentation & coding for appropriateness & accuracy in accordance to Medicare and American Medical Association (AMA) coding guidelines. Utilizes electronic medical… more
- Ochsner Health (Slidell, LA)
- …knowledge of managed care and public programs such as those funded by Medicare , Medicaid, Medicare Advantage, and commercial insurance plans. + Proficiency in ... apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards. This...and standards. This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including… more
- Robert Half Accountemps (Lewiston, ME)
- …to provide exceptional support and service to patients while ensuring compliance with organizational policies and regulatory requirements. In this role, you ... Accurately assign medical record numbers (MRNs) and perform medical necessity and compliance checks for patient admissions. * Collect and verify insurance details,… more
- State of Colorado (CO)
- …employee, Temporary Aides pay state, federal and local (if applicable) taxes, Medicare tax, and contribute to the Colorado Public Employees' Retirement Association ... purchase tobacco and alcohol beverage products from licensed establishments. These underage compliance checks aim to prevent sales of tobacco and alcohol beverages… 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
- Evolent (Frankfort, KY)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...part of the application process. This is collected for compliance and security purposes and only reviewed if an… more
- McLaren Health Care (Grand Blanc, MI)
- …customer service, software management, and tracking responses to the Centers for Medicare and Medicaid Services (CMS) Recovery Audit Contractor (RAC), Medicare ... facility claims. 3. Provides leadership for audit staff with training, compliance reviews, regulatory guidance, work distribution, and monitoring of accounts… more
- CVS Health (Tallahassee, FL)
- …to identify and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... setting. + Sound knowledge of coding guidelines and regulations to meet compliance requirements, such as establishing medical necessity. + Identify clinically active… more
- J&J Family of Companies (Baltimore, MD)
- …access and affordability solutions across multiple payer types and plans (ie, Medicare , Medicaid Managed Care, Commercial). + Execute business in accordance with the ... highest ethical, legal, and compliance standards, including timely and successful completion of all...payer approval processes and business acumen. + Understanding of Medicare , Medicaid, and private payer initiatives affecting reimbursement of… more
- UPMC (Pittsburgh, PA)
- …individuals with physical disabilities in the Commonwealth who are covered by Medicare and Medicaid. To provide service coordination services across the continuum of ... that OPS reporting is completed per regulatory deadline and compliance requirements. + Responsible for performing profession-level administrative duties involving… more