- PruittHealth (Norcross, GA)
- …concepts, and skills; Seeks and responds to regular performance feedback from team lead and provides upward feedback, as needed. 15. Assists in orientation and ... 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… more
- Point32Health (Canton, MA)
- …product strategies in collaboration with Product Strategy counterparts; and 2) lead key aspects of product implementation and administration processes, including ... design, regulatory requirements, and implementation feasibility. The Senior Manager may also lead some workgroups to help flesh out detailed requirements to support… more
- Ventura County (Ventura, CA)
- …reimbursement for Medi-Cal and/or Medicare and prepares reports; + Serves as lead biller/ specialist to the department; and + Performs other related duties as ... processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare , and general insurance...Claim Source to follow up on accounts. Medical Billing Specialist IV is the lead level class… 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
- Marshfield Clinic (Minocqua, WI)
- …to expedite and enhance the patient experience. The Patient Access Specialist Lead activities include appointment scheduling, referral completion, authorization ... the most exciting missions in the world!** **Job Title:** Patient Access Specialist Team Lead Float **Cost Center:** 301451102 Minocqua-Med Support Floats… 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
- 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
- Molina Healthcare (AZ)
- …Quality Interventions and Quality Improvement Compliance . + Acts as a lead specialist to provide project-, program-, and / or initiative-related direction ... and implementation of NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist , Quality… more
- Tufts Medicine (Lowell, MA)
- …the delivery of support services or activities, typically under supervision. A specialist level role that requires very advanced knowledge of operational procedures ... responsible. Must initiate any corrective action, including referral to the Team Lead or Supervisor when appropriate. 11. Reviews, evaluates and processes appeals… more
- HonorHealth (Phoenix, AZ)
- …of the study. The position's competencies include operations, coding/billing compliance , Medicare coverage analysis/budgeting, contracting, Clinical Trial ... finance and accounting principles. The successful Associate Clinical Trials Operations Specialist will support business activities of the Honor Health Research… more
- University of Washington (Seattle, WA)
- …workflows that allow for protocol adherence, data integrity, and ensure efficiency and compliance . The Clinical Trial Specialist will maintain daily and dynamic ... ability to understand clinical research coordination, revenue cycle development, budgeting, compliance , and regulations. The Clinical Trial Specialist is… more
- Centers for Medicare & Medicaid Services (Woodlawn, MD)
- …Division of Quality and Compliance (DQC). As a Supervisory Health Insurance Specialist , GS-0107-15, you will lead a staff responsible for the quality and ... compliance surrounding the operations and oversight of Medicare and Medicaid provider/supplier enrollment. Responsibilities Coordinate all facets of the… more
- Molina Healthcare (Seattle, WA)
- …goals. + Support internal Quality and VBC-related activities. + Acts as a lead specialist to provide project-, program-, and / or initiative-related direction ... education and facilitate meeting established goals. **Knowledge/Skills/Abilities** The Senior Specialist , Provider Engagement contributes to one or more of these… more
- Trinity Health (Troy, NY)
- …Notification Verification and Authorization (NoVA), Point of Service Cash Collection, Medicare Compliance , and Customer Service, across numerous state and ... pertaining to the healthcare industry. Ability to read, analyze, and interpret Medicare Compliance Regulations. + Working knowledge of third-party payer… more
- VNS Health (Manhattan, NY)
- …Works with all parties to address and resolve discrepancies to reduce financial and compliance risks to the plan. + Monitors Medicare Part D Reconciliation ... membership. + Monitors processing of membership activities in order to confirm compliance with CMS and DOH guidance. Reviews Membership Files to validate adherence… more
- Trinity Health (Westerville, OH)
- …relation between diagnosis and procedure using CPT and ICD-9 coding to ensure compliance with third party regulations. Understands Medicare , Medicaid and other ... **Employment Type:** Part time **Shift:** **Description:** Patient Financial Specialist I ensure the complete and accurate registration of patients in the Emergency… more
- Elevance Health (Indianapolis, IN)
- **SCA Data Specialist ** _Location: This is a virtual position, the ideal candidate will live within 50 miles of one of the following NGS Elevance Health Pulse Point ... $21.36 + Harrisburg, PA - $20.72 The **SCA Data Specialist ** is responsible for researching and collecting data for...contract. The ideal candidate will possess working knowledge of Medicare , preferably with experience in Part B. Proficiency in… more
- Trinity Health (Newtown, PA)
- …**Description:** Trinity Health, Mid-Atlantic, is looking for an Insurance Verification Specialist to join our team! Employment Type: Full-time Schedule: Tues-Thurs ... Friday - 9:00am-5:30pm Saturday - 7:30am-4:00pm The Insurance Verification Specialist is responsible for obtaining and verifying accurate insurance information,… more
- University of Washington (Seattle, WA)
- …**has an outstanding opportunity for a** **_Temporary>_** **Clinical Trials Budget Specialist ** **to join their team!** The Central Admin Clinical Trials Budget ... Specialist is responsible for clinical research budgeting and revenue...investigator initiated and industry sponsored clinical trials, ensuring regulatory compliance and fiscal accountability. This position is also responsible… more
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