- Centene Corporation (Cheyenne, WY)
- …home anywhere in the Continental United States.** **Position Purpose:** Supports the Medicare Communications Compliance team in the management of regulatory ... requirements associated with the Medicare materials and sales compliance . Participates the ongoing oversight, analysis, review, and approval of all… more
- HCA Healthcare (Nashville, TN)
- …**_Note: Eligibility for benefits may vary by location._** We are seeking a Medicare Specialist for our team to ensure that we continue to ... meaningful as we do. We want you to apply! **Job Summary and Qualifications** The Medicare Specialist will be responsible for all aspects of Medicare … more
- Commonwealth Care Alliance (Boston, MA)
- …reimbursement, public health care programs and reimbursement methodologies (Medicaid and Medicare ) + Medical Coding, Compliance , Payment Integrity and Analytics ... under the direction of the Sr. Director, TPA Management and Claims Compliance , Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing… more
- BlueCross BlueShield of North Carolina (NC)
- …complex coding patterns and reports relevant data to the Centers for Medicare and Medicaid Services (CMS). **What You'll Do** + Analyzes necessary documentation, ... coding and reports relevant data to the Centers for Medicare and Medicaid Services (CMS). + Uses all resources...Medicaid Services (CMS). + Uses all resources to ensure compliance and understanding of the CMS Hierarchical Condition Category… more
- Commonwealth Care Alliance (Boston, MA)
- … Medicare , and commercial payment methodologies and supports audit, compliance , and provider engagement initiatives. This role also provides support in ... have direct reports. **Essential Duties & Responsibilities:** + Analyze MassHealth and Medicare claim reimbursements to ensure compliance with contractual terms,… more
- Adecco US, Inc. (Monroeville, PA)
- …Experience and Skills:** + 1 year **of medical billing experience** ( Medicare experience preferred). + Strong computer skills, including proficiency in **Microsoft ... support the pharmacy revenue cycle by assisting with insurance verification, billing, compliance , and customer service. You'll play a key part in ensuring accurate… more
- SUNY Upstate Medical University (Syracuse, NY)
- …resources. Ensure accurate coding and documentation to support quality initiatives and Medicare compliance . Work closely with clinical teams across seven Primary ... is seeking a Registered Nurse (RN), or Certified Nurse Specialist (CNS), to coordinate and conduct Medicare ...Nurse Specialist (CNS), to coordinate and conduct Medicare Annual Wellness Visits (AWVs) across seven Primary Care… more
- Trinity Health (Livonia, MI)
- …and periodic risk assessments in support of the Trinity Health Integrity & Compliance Program (ICP). Risk assessments consider legal and regulatory compliance ... Health & Human Services (DHHS) - Office of Inspector General (OIG), Centers for Medicare & Medicaid Services (CMS), Department of Justice (DOJ) as well as input… more
- Elara Caring (Dallas, TX)
- …Right Care, at the Right Time, in the Right Place. **Job Description:** The Compliance Specialist ensures compliance with all government mandated regulations ... Elara departments and branch locations through effective communication and site visits. The Compliance Specialist assists the Director of Compliance in… more
- Commonwealth Care Alliance (Boston, MA)
- …Summary: Reporting to the Director, Claims Operations & Quality Assurance, the Regulatory Compliance & Audits Sr. Specialist II is responsible for ensuring CCA's ... and federal healthcare regulations, particularly MassHealth (Massachusetts Medicaid) and CMS Medicare requirements. This role is housed within the Claims Operations… more
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