- Molina Healthcare (Houston, TX)
- **(Sales) Compliance Analyst ** Molina Healthcare's Medicare Compliance team supports sales operations for the Molina Medicare product lines. It is a ... corporate function supporting compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Sales Compliance Analyst position is primarily responsible for Sales… more
- Humana (Boise, ID)
- …a part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the ... requirements development. + Creating and executing comprehensive test plans + Ongoing Medicare Pricer maintenance, quality assurance, and compliance + Determine… more
- Dana-Farber Cancer Institute (Brookline, MA)
- The Medicare Coverage Analyst (MCA) is responsible for reviewing clinical research protocols, Informed Consent Forms, Clinical Trial Agreements, and other ... to patient insurance and which should be billed to the study sponsor.The Medicare Coverage Analyst determines whether proposed clinical research studies are a… more
- Geisinger (Danville, PA)
- …our team. The ideal candidate will have a strong understanding of Medicare settlement processes, compliance requirements, and hospital reimbursement regulations. ... data, identify trends, and prepare accurate accounting journal entries, ensuring compliance with federal and state guidelines. Proficiency in Microsoft Excel at… more
- Highmark Health (Pittsburgh, PA)
- …and technology experience + Operational improvement experience + Experience in Medicare or other Government lines of business **LICENSES OR CERTIFICATION** ... **Required** + None **Preferred** + Process Improvement certification (ie Lean, Six Sigma or Kaizan) **SKILLS** + Broad application of principles, theories, and concepts in strategic thinking, plus working knowledge of other related fields + Strong PC… more
- Highmark Health (Pittsburgh, PA)
- …and technology + Experience in operational improvement + Experience in Medicare or other Government lines of business. **LICENSES or CERTIFICATIONS** **Required** ... + None **Preferred** + None **SKILLS** + Broad application of principles, theories, and concepts in strategic thinking, plus working knowledge of other related fields + Strong PC application Skills (MS Office including PowerPoint and Excel) + Knowledge of… more
- Rush University Medical Center (Chicago, IL)
- …**Summary:** Reporting to the Manager of Compliance audit, the Corporate Compliance Regulatory Analyst plays a critical role in ensuring Rush University ... allegations. 2. Perform targeted reviews of documentation and billing to ensure compliance with Medicare Teaching Physician guidelines and conditions of payment.… more
- OhioHealth (Columbus, OH)
- …Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position ... will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid) reimbursement is received for OhioHealth. * This position is primarily… more
- J&J Family of Companies (Titusville, NJ)
- …Johnson & Johnson Innovative Medicine is recruiting for a Lead Financial Analyst , Government Contract Compliance . This position is based in Titusville, ... for providing strategic support to the Johnson & Johnson Government Contract Compliance (GCC) team within Innovative Medicine US Commercial Finance. Operating in a… more
- Commonwealth Care Alliance (Boston, MA)
- …Working under the direction of the Sr. Director, TPA Management and Claims Compliance , Healthcare Medical Claims Coding Sr. Analyst will be responsible for ... reimbursement, public health care programs and reimbursement methodologies (Medicaid and Medicare ) + Medical Coding, Compliance , Payment Integrity and Analytics… more
- Hunterdon Health Care System (Flemington, NJ)
- …Promotes education for self and others by means of webinars and teleconferences offered by Medicare + General & Medicare Compliance : Medicare and Coding ... Responsible for application and maintenance of medical necessity software, insuring compliance relating to Medicare billing requirements, conducting internal… more
- Prime Therapeutics (Columbia, SC)
- …Come build the future of pharmacy with us. **Job Posting Title** Senior Compliance Analyst (Regulatory Change Management) - Remote **Job Description** The Senior ... Compliance Analyst assists in the implementation of...organization, or other highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) Must… more
- Prime Therapeutics (Little Rock, AR)
- …career? Come build the future of pharmacy with us. **Job Posting Title** Senior Compliance Analyst - Remote **Job Description** The Senior Compliance ... Analyst assists in the implementation of Prime's compliance programs and leads initiatives within their designated areas. This role partners with key internal… more
- Houston Methodist (Bellaire, TX)
- At Houston Methodist, the Sr Compliance Coding Analyst position is responsible for supporting accurate billing and coding compliance with Medicare and ... reviews and identifying potential risk areas and revenue potential. The Sr Compliance Coding Analyst position partners with stakeholders to provide feedback… more
- Centene Corporation (Austin, TX)
- …and leads the identification, implementation, and maintenance of Duals and overlapping Medicare compliance policies, procedures and work instructions. + Leads ... fully remote. The ideal candidate will have experience or working knowledge of compliance laws and regulations, specifically related to Medicare , D-SNP, and… more
- Mount Sinai Health System (New York, NY)
- …and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's subject ... Contracts across the Mount Sinai Health System. MSHP seeks a Senior Contract Compliance (Professional Billing) Analyst who will primarily be responsible for… more
- Abbott (Austin, TX)
- …for developing, updating and maintaining basic and routine elements of Abbott's compliance program at the franchise, business unit, divisional or corporate level. + ... administration of division monitoring plan. Core Job Responsibilities + The Analyst performs the following with moderate supervision from the OEC Manager/Director… more
- BayCare Health System (Clearwater, FL)
- …judgment at all times. **Minimum Qualifications:** **Experience:** + 5 years of Medicare compliance experience **Education:** + Required - Bachelors - Business; ... be working remotely?** Hybrid Equal Opportunity Employer Veterans/Disabled **Position** Compliance Analyst - Insurance Division **Location** Clearwater:Park… more
- Highmark Health (Concord, NH)
- …:** **JOB SUMMARY** This job partners with business units to ensure compliance to rules, regulations, policies, and procedures of governmental, contractual, and/or ... trends, and/or contract changes. **ESSENTIAL RESPONSIBILITIES** + Manage and coordinate compliance related processes. + Monitor governance and compliance of… more
- University of Miami (Coral Gables, FL)
- …Research Administration (ORA) has a great job opportunity for an ORA Contracts and Grants Analyst 3 to work at the University of Miami. CORE JOB SUMMARY The ORA ... Contract and Grants Analyst 3 provides financial and administrative oversight of complex...and supports institutional policies and procedures related to research compliance and administration. CORE JOB FUNCTIONS + Oversees general… more
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