- Catalent (Philadelphia, PA)
- …located in the Philadelphia area is Catalent's global Center of Excellence for Clinical Supply Packaging. Catalent offers GMP secondary packaging and clinical ... by supporting activities of the Manager, Quality Systems which may include audit support activities, GMP training and Compliance Wire support.Assist hiring managers… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Bring your true colors to blue. What We Need Reporting to the Associate Director of Professional Reimbursement Strategy, the Payment Policy and Network ... + Support with physician fee schedules + Develop /manage audit criteria for payment policy reimbursement opportunities...years directly work in payment reimbursement policy, payment integrity and/or clinical editing + Proficient… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. **Primary Function/General Purpose of Position** Under ... protocols that align with Bon Secours Mercy Health's overall compliance audit and compliance responsibilities relative to acute and physician revenue cycle… more
- Humana (Oklahoma City, OK)
- …of our caring community and help us put health first** The Compliance Audit Nurse is responsible for auditing care management activities and documentation to ensure ... adherence to policies, procedures, and regulations. The Compliance Audit Nurse work assignments are varied and frequently require...state of Oklahoma with no discrepancies + 3+ years clinical nursing experience + 1+ years Prior Compliance Auditing… more
- Brookdale Senior Living (Brentwood, TN)
- Overview Brookdale seeks experiencedDirector of Clinical Reimbursementto support our SNF Portfolio. This opportunity is based out of our Brentwood, TN corporate ... Reimbursement + Pet Insurance + Adoption Reimbursement Benefits + Variety of Associate Discounts This is an incentive based position, which may include bonuses,… more
- Immigration and Customs Enforcement (Miami, FL)
- …evaluating clinical case reviews for adequacy of care, compliance with clinical and regulatory guidelines, overpayment, and audit recovery; and developing ... Health Service Corps (IHSC), Office of Deputy Assistant Director of Clinical Services (DAD-CSU). This is a supervisory position. Responsibilities PROFESSIONAL DUTIES… more
- Fresenius Medical Center (Waltham, MA)
- PURPOSE AND SCOPE: The Clinical Project Manager is a high impact, leadership role responsible for key elements of program execution within Frenova's Team. The CPM ... level of quality possible. The CPM monitors and tracks the progress of clinical study activity at research sites ensuring compliance with all local, state and… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- **37429BR** **Extended Job Title:** Sr Medical Billing Associate (MPIP/Alberta) **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** ... works with Accounting Services Department to void, do stop payment or re-issue checks. Mail patient and insurance refund...insurance refunds for the Institutional Office of Compliance and/or Audit Services timely and accurately as defined by their… more
- Taiho Oncology (Princeton, NJ)
- Associate Director, PV Sciences Pleasanton, CA, USA * Princeton, NJ, USA Req #361 Monday, April 22, 2024 Looking for a chance to make a meaningful difference in the ... and evolving needs of patients. Advanced technology, a world-class clinical development organization, and state-of-the-art facilities: these and other resources… more
- Catalent Pharma Solutions (Morrisville, NC)
- …Catalent Pharma Solutions is Morrisville, NC is hiring a Analytical Quality Assurance Associate for the Analytical group. The Analytical Quality Associate will ... and is also home to Catalent's Inhalation franchise including product development, clinical and commercial manufacturing for pMDI, DPI and Nasal Sprays. **Catalent… more
- Fallon Health (Worcester, MA)
- …among the nation's top health plans for member experience, service, and clinical quality. Fallon Health's Summit ElderCare(R) is a Program of All-Inclusive Care ... time **Responsibilities** **Primary Job Responsibilities** **Is responsible for ensuring accurate payment of the PACE medical claims** : + Responsible for managing… more
- Trinity Health (Chelsea, MI)
- …Inform patients on cost of treatment, insurance benefits, resources for payment and financial assistance. Secures and documents payment arrangements. ... Obtains medical authorization or referral forms, if appropriate. Audit authorizations for accuracy and determine if delay/deny policy needs to be invoked. Utilizing… more
- Bassett Healthcare (Cooperstown, NY)
- …and timely revenue capture. May have direct revenue responsibility through payment collection, cash handling, processing of insurance eligibility and managed care ... is entered or scanned into the system accurately as monitored by system audit Accurate confirmation of attending PCP and Billing PCP, when appropriate. Assures… more
- Bassett Healthcare (Cooperstown, NY)
- …and timely revenue capture. May have direct revenue responsibility through payment collection, cash handling, processing of insurance eligibility and managed care ... is entered or scanned into the system accurately as monitored by system audit Accurate confirmation of attending PCP and Billing PCP, when appropriate. Assures… more
- Bassett Healthcare (Cooperstown, NY)
- …and timely revenue capture. May have direct revenue responsibility through payment collection, cash handling, processing of insurance eligibility and managed care ... is entered or scanned into the system accurately as monitored by system audit Accurate confirmation of attending PCP and Billing PCP, when appropriate. Assures… more
- Walworth County (Elkhorn, WI)
- …the consumer's status, as required by program mandates. Provide ongoing clinical assessment of mental status and symptomatology. Adjust treatment interventions to ... 51, 55, 92 and 94. Maintain accurate and timely clinical records and documentation in accordance with federal, state...initial and ongoing documentation training to contracted service providers. Audit all progress notes received to ensure that the… more
- Ventura County (Ventura, CA)
- …+ Educational Incentive - An educational incentive of 2.5% for completion of an associate degree, 3.5% for completion of a bachelor's degree, OR 5% for completion of ... teaching facility using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10CM); International Classification of Diseases, Tenth Revision,… more
- Cleveland Clinic (Cleveland, OH)
- …+ Support accreditation, audit and other compliance activities related to the clinical use of the EHR + Assist in gathering, managing and prioritizing ... experienced and enthusiastic leader and clinician focused on the development of clinical information systems that enable the delivery of safe, effective, and… more
- Highmark Health (Jefferson City, MO)
- …OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and ... identified in the audits compliant with regulatory requirements. Provides written audit guidance. Participates with management in the assessment of external … more
- LifePoint Health (Brentwood, TN)
- …and Education**youwill review accounts for accurate and appropriate coding and/or clinical documentation integrity (CDI) in accordance with the Company's policies ... Management Association (AHIMA) Standards of Ethical Coding, The Association of Clinical Documentation Improvement Specialist (ACDIS) Code of Ethics, Official Coding… more
