- Trinity Health (Des Moines, IA)
- …basics of coding diagnoses and procedures as required for insurance authorizations and Medicare compliance . Utilizes online program for Medicare ... tracking system; distributes patient information according to hospital policy and compliance regulations. Obtains State issued photo ID. Identifies and selects the… more
- CenCal Health (Santa Barbara, CA)
- …complex AMO activities of internal departments and external partners to ensure compliance with Medi-Cal and Medicare regulatory and contractual requirements, and ... and Responsibilities: GENERAL: Directs and conducts routine and complex compliance audit activities of internal departments and/or external partners, documenting… more
- The Christ Hospital (Cincinnati, OH)
- …Necessity guidelines have been met. Prepares and completes documentation that establishes Medicare Compliance such as Medicare Secondary Payor Questionnaire ... regarding accounts to maximize reimbursement. Maintain knowledge of current HMO/PPO/Medicaid/ Medicare /commercial insurance regulations and requirements. Requires working knowledge of… more
- Lundbeck (Edmond, OK)
- …anticipate and effectively address payer access issues (IDNs, Medicare , Medicaid, Commercial) using Lundbeck resources. Pharmaceutical Environment/ Compliance ... - Ability to apply knowledge of pharmaceutical and regulatory environment, including accountability and adherence to Lundbeck policies and procedures and FDA regulations regarding the promotion of pharmaceutical and medical products. REQUIRED EDUCATION,… more
- U-Haul (Phoenix, AZ)
- …tracking, and policyholder communications . This position assists in ensuring compliance with Medicare Supplement regulations, coordinating with internal teams ... 2721 N Central Ave, Phoenix, Arizona 85036 United States of America he Regulatory Compliance Analyst supports the Compliance , Actuarial, and Finance teams in the… more
- Lundbeck (Raleigh, NC)
- …anticipate and effectively address payer access issues (IDNs, Medicare , Medicaid, Commercial) using Lundbeck resources. Pharmaceutical Environment/ Compliance ... - Apply knowledge of pharmaceutical and regulatory environment, including accountability and adherence to Lundbeck policies and procedures and FDA regulations regarding the promotion of pharmaceutical and medical products. REQUIRED EDUCATION, EXPERIENCE and… more
- Novo Nordisk Inc. (WA)
- …as other Market Access & Public Affairs teams, Medical, Legal, Compliance , Communications and other key stakeholders locally and globally. External relationships ... Tax, Trade, Intellectual Property, Supply Chain, Private Health Insurance, Medicare , Medicaid, Reference Pricing, Pricing / Price Increases, Reimbursement, Privacy,… more
- Randstad (Houston, TX)
- …of experience is required) open enrollment (1 year of experience is required) Medicare /Medicaid Medicare Compliance Sales Qualifications Years of experience: ... 2 years Experience level: Experienced Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …to internal partners including but not limited to Member Service, Medicare Operations, Compliance , Legal, Medical Directors, Sales/Marketing/Product and external ... to ensure that all Commercial (Pharmacy and Medical benefits) and Medicare Advantage Part D coverage determination requests are processed consistently, timely… more
- FC Compassus LLC (Lorain, OH)
- …developing corrective approaches to improve care or prevent delays. Is knowledgeable of Medicare compliance standards and assures that these standards are met. ... appropriately reports and responds to problems/incidents that involve safety and compliance issues. Holds self, employees and co-workers accountable for keeping… more
- AdvisaCare (Saginaw, MI)
- …as needed Compliance with AdvisaCare Hospice Policies and Procedures, Medicare compliance Consulting with and educating the patient/family on disease ... process, self-care techniques, end-of-life care, dealing with issues of ethical concern Supervision of paraprofessionals providing services to patient Preparing clinical and progress notes, participating in IDG conferences Participate in Hospice performance… more
- Johns Hopkins Healthcare (Springfield, VA)
- …wellness programs and MORE! Who you are: As a Field Sales Representative for Medicare Advantage, you are passionate about the health and well-being of our members ... Manassas) Must have an active Health insurance license and experience selling Medicare in Northern VA. What you'll do: Identify prospective Medicare -eligible… more
- Tennr (New York, NY)
- …Have Experience in both healthcare and SaaS environments. Familiarity with payer-side compliance topics (eg, Medicare FWA, state regulations). Exposure to ... top investors. Role Description We're hiring a Director of Compliance to build and lead a cross-functional compliance... Compliance to build and lead a cross-functional compliance program that spans both healthcare regulation and enterprise… more
- Sevita (Minneapolis, MN)
- …codes, UB-04, and HCFA-1500 forms Strong understanding of medical collections compliance , Medicare , Medicaid, Medicaid managed care, Commercial, Workers Comp, ... cash moves, sales adjustments, and transfer of liability Ensure internal control compliance with all assigned areas and other audit requirements Maintain an… more
- Randstad (Houston, TX)
- …needs and recommend appropriate plans based on eligibility and budget. Ensure compliance with state and federal regulations regarding health insurance sales. Provide ... client relationships. Skills Call Center Follow-up Active Listening Telephone Etiquette medicare sales (2 years of experience is required) licensed health insurance… more
- Enhabit Home Health & Hospice (Rocky Hill, CT)
- …in Rocky Hill, CT , ensuring the highest standards of patient care and compliance with Medicare regulations. In this role, you will provide leadership, guidance, ... will serve you well in this rewarding role, and an excellent knowledge of OASIS and Medicare guidelines is most helpful as you will be reviewing plans of care on a… more
- CVS Health (Atlantic City, NJ)
- …part of a growing business segment, selling our competitive portfolio of Medicare products. Upon acquisition the Field Sales Representative will own the member ... (AHIP) Continued Education (CE's) Product Certification Required Security and Compliance Client/Carrier Certifications Any required CMS Certifications Required Qualifications… more
- VIBRANTCARE REHABILITATION, Inc. (Sacramento, CA)
- …basis and adhere to the policies and procedures set forth. Complete all Medicare compliance trainings as required by regulations and/or VibrantCare policies. ... Complete Occupational Safety and Health Administration (OSHA) training on a yearly basis and adhere to standards set forth in OSHA standards and other governmental regulations. Clean and prepare treatment areas and equipment following OSHA guidelines. Carry… more
- Kaiser Permanente (Oakland, CA)
- …issues, and trigger events by developing mitigation plans and strategies. Monitors compliance of program activities by ensuring program plans and team members adhere ... NUE-PO-01|NUE|Non Union Employee Job Level: Individual Contributor Department: Po/Ho Corp - Medicare LOB Admin - 0308 Pay Range: $130200 - $168410 / year… more
- UF Health (Gainesville, FL)
- …billing claims according to Federal/Managed Care rules, regulations and compliance guidelines, patient account research and resolution, insurance verification and ... benefits determination, identification of reimbursement issues, resolution of credits and issuance of refunds, identification of payment variance invoices, follow up and resolution of denied claims. Qualifications Minimum Education and Experience Requirements:… more
