- Molina Healthcare (ID)
- **Job Description** **Job Summary** Establish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and ... the Health Care environment. Ensures the Business' accountability for compliance by overseeing, follow-up and resolution of investigations. **Knowledge/Skills/Abilities**… 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 ... Nurse (RN), or Certified Nurse Specialist (CNS), to coordinate and conduct Medicare Annual Wellness Visits (AWVs) across seven Primary Care clinics. This role… 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
- CVS Health (Hartford, CT)
- …monitoring and tracking and Utilization Management Strategy support * Collaborative work with Medicare Quality and Compliance on an ongoing basis * Develop ... Responsibilities of this Medical Director role are related to Medicare Appeals. * Direct daily work on part C...subject matter expertise on Medicare policy for the enterprise * Provide ongoing education… more
- Community Health Systems (Palmer, AK)
- …are submitted in accordance with regulatory guidelines and organizational policies. The Medicare Billing Specialist supports compliance with federal and state ... As a ** Medicare Billing Specialist** at **Susitna Surgery Center** you'll...Ensures documentation and billing practices align with audit and compliance expectations. + Escalates unresolved billing issues or delays… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …of research activity in an academic medical center + Knowledge of billing compliance and Medicare regulations/policy, applicable federal, state, and local laws, ... fully remote with the ocassional time onsite as needed.** The Sr. Medicare Coverage Analyst (MCA) is responsible for reviewing clinical research protocols, Informed… more
- Henry Ford Health System (Troy, MI)
- …and planning and marketing support. Coordinate the development and implementation of Medicare Advantage sales strategies, compliance activities and oversight for ... SUMMARY: Responsible for the retention and growth of the Medicare line of business (both Individual and Group) accounting...Information + Organization: HAP (Health Alliance Plan) + Department: Medicare & Individual Sales + Shift: Day Job +… more
- Centene Corporation (Austin, TX)
- …and leads the identification, implementation, and maintenance of Duals and overlapping Medicare compliance policies, procedures and work instructions. + Leads ... Duals and SMAC regulatory filings. + Manages Duals (and Medicare with D-DSNP specific or separate) compliance ...(and Medicare with D-DSNP specific or separate) compliance reporting responsibilities and respond to inquiries from state… more
- City of New York (New York, NY)
- …a variety of topics, including legal ethics, conflicts, privileges, federal grants, Medicare compliance , and outside employment. Division attorneys also conduct ... position of Assistant Corporation Counsel in the Ethics & Compliance Division. Attorneys with more than five years of...Senior Counsel position in the division. The Ethics & Compliance Division has counseling and ligation adjacent roles and… more
- Actalent (Boston, MA)
- …trials. + Experience in oncology. + Knowledge of medical billing and billing compliance . + Understanding of Medicare coverage policies. Additional Skills & ... Qualifications + Experience in billing compliance . + Proficiency in Medicare coverage analysis. + Background in clinical research. Work Environment This position… more
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