- Centene Corporation (Raleigh, NC)
- …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 in the ongoing oversight, analysis, review, and approval of all… more
- CVS Health (Nashville, TN)
- …sales talent! We have an exciting opportunity available for highly motivated individuals as Medicare Sales Specialist . The position will be a part of a ... specialized team who will focus on educating existing Medicare members on available plan offerings to help meet...selling applicable products to existing members. + Maintaining high compliance commitment and standards with a robust knowledge with… more
- PruittHealth (Norcross, GA)
- …with members of own and other teams to communicate effectively and ensure compliance with cross-team responsibilities. 17. Carries out all duties with a "Commitment ... to Caring" attitude in accordance with PruittHealth's mission, vision, and philosophy. **KNOWLEDGE, SKILLS, ABILITIES:** * In-depth knowledge of various billing documentation requirements, the patient accounting system, and various data entry codes to ensure… more
- Point32Health (Canton, MA)
- …business performance needs of each market. All responsibilities extend to any new Medicare markets should Point32Health choose to expand its footprint in the future. ... questions that may arise during desk review, review of Medicare Plan Finder (MPF) for accuracy, etc. + Support...business functions, etc. + Oversee or collaborate with Product Specialist to manage Benefit Adjudication Committee meetings and other… more
- Ventura County (Ventura, CA)
- …and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare , and general insurance reimbursement ... Medicare and prepares reports; + Serves as lead biller/ specialist to the department; and + Performs other related...with billing and processing claims for timely reimbursement and compliance with Medi-Cal, Medicare , and general insurance… more
- Axis (New York, NY)
- …request for candidates taking part in the selection process. AXIS Capital Claims Compliance Specialist , Claims Shared Services- Job Description AXIS is seeking a ... Claims Quality Assurance and Compliance Specialist , Claims Shared Services to join...Claims with an immediate focus on Adjuster Licensing and Medicare Compliance . The successful candidate is a… more
- CareOregon (Portland, OR)
- Job Title Compliance Specialist Requisition # 24592 Exemption Status Exempt Management Level n/a Direct Reports n/a Manager Title Compliance Manager ... go into the Downtown Portland office. Job Summary The Compliance Specialist is responsible for supporting the...Skills and Abilities Required Knowledge + Growing knowledge of Medicare and Medicaid compliance practices and procedures… more
- Trinity Health (Livonia, MI)
- …or all hours being remote. This role is within the Integrity and Compliance department of IAS in the professional services Center of Excellence, providing support ... for the seven elements of an effective compliance program. This role is primarily responsible for the...services which relies on a thorough understanding of the Medicare Physician Fee Schedule, Medicare Claims Processing… more
- CareOregon (Portland, OR)
- …for remote positions must reside in Oregon or Washington. Job Title Sr Compliance Specialist Exemption Status Exempt Management Level n/a Direct Reports n/a ... role, but you must reside in Oregon or Washington. Job Summary The Sr Compliance Specialist is responsible for supporting administration of compliance … more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Compliance Audit Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... achieve that purpose. Job Summary The Customer Solution Center (CSC) Audit Readiness Specialist II is responsible for the execution, oversight, and monitoring of the… more
- Josselyn (Northbrook, IL)
- Job Summary The Payroll and Compliance Specialist is the expert on payroll operations, employment and payroll-related HR compliance , and payroll systems. Key ... processing biweekly payroll, conducting regular reconciliations and audits, ensuring compliance with payroll and HR regulations, and developing training programs… more
- Harvard University (Cambridge, MA)
- …Office Location:USA - MA - Cambridge Business Title:Tax Compliance Specialist ISub-Unit: Salary Grade (https://hr.harvard.edu/salary-ranges#ranges) :054Time ... on payments to non-U.S. individuals and entities. The Tax Compliance Specialist develops knowledge of IRS Chapter...assistance + Review requests for standard social security and Medicare tax exemptions based on immigration and student status… more
- Trinity Health (Livonia, MI)
- …or all hours being remote. This role is within the Integrity and Compliance department of IAS in the professional services Center of Excellence, providing support ... for the seven elements of an effective compliance program. This role is primarily responsible for the...services which relies on a thorough understanding of the Medicare Physician Fee Schedule, Medicare Claims Processing… more
- University of Utah (Salt Lake City, UT)
- Details **Open Date** 11/19/2024 **Requisition Number** PRN40385B **Job Title** Compliance Specialist **Working Title** Safety Compliance Specialist ... 60,000 **Close Date** 02/19/2025 **Priority Review Date** **Job Summary** Provides compliance related coding reviews and auditing of faculty and physician… more
- Molina Healthcare (AZ)
- …and implementation of NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist , Quality ... or more of these quality improvement functions: Quality Interventions and Quality Improvement Compliance . + Acts as a lead specialist to provide project-,… more
- Molina Healthcare (MA)
- …occasional support for member-focused quality initiatives.** **KNOWLEDGE/SKILLS/ABILITIES** The Specialist , Quality Interventions/ QI Compliance contributes to ... provides direction and implementation of NCQA accreditation surveys and federal/state QI compliance activities. **The focus of this position will be member outreach… more
- Ventura County (Ventura, CA)
- …and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare , and general insurance reimbursement ... Medical Billing Specialist I/II Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4658466) Apply Medical Billing Specialist I/II Salary… more
- Tarrytown Rehabilitation & Nursing Center (Everett, MA)
- …Ensures compliance with federal and state regulations, MA Medicaid, Medicare and Managed Care payment systems. Monitors, consults, and makes effective ... CLINICAL REIMBURSEMENT SPECIALIST / MULTI FACILITY We offer competitive compensation and...and MA Medicaid payment methodology. + Extensive knowledge of Medicare reimbursement, compliance , and eligibility. Knowledge, Skills,… more
- New York State Civil Service (Thiells, NY)
- …Yes Agency People With Developmental Disabilities, Office for Title Medical Specialist 2 Occupational Category Health Care, Human/Social Services Salary Grade 38 ... on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal...in Canada AND meet the other requirements for Medical Specialist 1 or 2, you are also eligible if… more
- Medical Mutual of Ohio (OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Under direct supervision, ... into the various modules of the Provider Data Management System. Supports compliance with standards set by individual states, federal and accrediting organizations… more
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