- Excellus BlueCross BlueShield (Rochester, NY)
- …investigating and remediating allegations of FWA while adhering to compliance and regulatory requirements. Primary activities include substantiating referrals, case ... accuracy of information provided to providers, regulators, law enforcement, Legal, Compliance and outside counsel. Prepares cases for prosecution, civil settlement,… more
- Fresenius Medical Center (Kennesaw, GA)
- …(HIPP), the Indigent Waiver (IW), Employer Group Health Plans (EGHP), Medicare , Medicaid, Medigaps, Commercial Exchange, Commercial Individual, Medicare ... values, and customer service philosophy. Adhere to the FMCNA Compliance Program, including following all regulatory and FMS policy...patients on dialysis for the purpose of paying their Medicare Part B, Medicare Advantage, Medigap, Commercial… more
- University of Utah Health (Salt Lake City, UT)
- …+ This position is responsible to work with the acutely admitted Traditional Medicare , Medicare Advantage, Commercial, Federal, State and unfunded patients. + It ... LOS, high dollar and frequent utilizers. + Collaborate with unit case manager , utilization review nurse and other organization staff on establishing an appropriate… more
- Stony Brook University (Stony Brook, NY)
- …logs, etc. Leads the staff in a professional manner and assures staff compliance with all relevant laboratory and hospital policies and procedures. + Represents ... c. Lab IT Implementation Team: Specimen Receiving LIS System Manager . As LIS System Manager of the...result reporting; manual billing; and review billing invoices for compliance . Specifics include: finding the requested esoteric tests by… more
- Corewell Health (Livonia, MI)
- …pm Job Summary Under the direction of the Patient Access Registration Front Line Manager , the Acute Care Hospital Registrar 1 is accountable to ensure a smooth ... information, educating and providing information as necessary. Collects and documents Medicare Questionnaire, issue Medicare Inpatient Letter & Medicare… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Responsibilities** **Group ... standard formulas and actuarial information, recognizing system requirements and ensuring compliance with state and federal regulations, and adherence to internal… more
- CenterWell (Hermitage, TN)
- …in on-call rotation and support growth initiatives at your center. + Ensure compliance with all licensing and accreditation requirements. + Spend 100% of your time ... experience. + Experience in value-based care, primary care or Medicare Advantage settings. + Active DEA license and ...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- CenterWell (Charlotte, NC)
- …in on-call rotation and support growth initiatives at your center. + Ensure compliance with all licensing and accreditation requirements. **Use your skills to make ... email, etc.). **Preferred:** + Experience in value-based care, primary care or Medicare Advantage settings. + Active DEA license and Medicare /Medicaid provider… more
- CenterWell (Jacksonville, FL)
- …on-call rotation and support growth initiatives at your center. + Ensure compliance with all licensing and accreditation requirements. **What We're Looking For** ... email, etc.). **Preferred:** + Experience in value-based care, primary care or Medicare Advantage settings. + Active DEA license and Medicare /Medicaid provider… more
- CenterWell (Newport News, VA)
- …on-call rotation and support growth initiatives at your center. . Ensure compliance with all licensing and accreditation requirements. What We're Looking For ... Preferred: . Experience in value-based care, primary care or Medicare Advantage settings. . Active DEA license and ...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more