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Evaluate activities of lending and transaction support personnel in the Corporate Bank and Credit Risk Management, ensuring compliance with policies, approvals, monitoring and risk assessment. 10+ years of senior experience in wholesale credit risk in an underwriting or adjudication capacity, or as a bank examiner focused on wholesale credit.
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Leads weekly and monthly compliance audits in the following claims processing areas: claims acknowledgement, adjudication turnaround time, lag, pending inventory, provider unbundling patterns, interest payments, handling of misdirected claims, completion of data sweeps, and other focused audits.
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Maintain the property so it is in compliance with all local, state, and federal laws (fire, backflow, OSHA, etc. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, or by fax at (202) 690-7442.
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Collaborate with Cybersecurity to ensure TE compliance (using tools such as Nessus, Splunk, Ivanti, and locally procured software. DCSA Consolidated Adjudication Services (DCSA CAS), an agency of the Department of Defense, handles and adjudicates the security clearance process.
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Ensure that all NCQA and other accreditation standards are met; ensure compliance with accurate coding and documentation standards, STAR, HEDIS measures. Establish a direct relationship with key departments, including pharmacy, underwriting, medical adjudication, claims, and provider relations, and assist with issues and/or concerns.
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The Associate Director, Medicaid Rebates Operations will lead the Medicaid team to ensure compliance with the Medicaid Drug Rebate Program, handling all Medicaid obligations for Novartis and its affiliates.
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This position will provide legal support to TAB with respect to the handling of litigation matters, complex subpoena responses, dispute resolution related to the operation of the Transit Adjudication Bureau.
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Explains HealthEquitys administrative capabilities as a result of these decisions, including claims adjudication and payment; debit card functionality; payroll, enrollment and eligibility file interactions; carrier integrations; compliance changes, etc11.
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Follow established HIPAA, Compliance & Security policies. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process.
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With general direction and considerable latitude for independent judgment and discretion, the Senior Service Delivery Manager is the primary point of contact for assigned client accounts. Additionally, the Senior Service Delivery Manager will improve client loyalty through flawless execution.
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Study Strategy: Provides the strategic direction to Biostats Data Mgmt & Data Ops for EDC, edit checks, data quality listings, SAP, Data Mgmt plan; Reviews patient population and protocol compliance for consistency with study strategy; Develops biomarker strategy in collaboration with Translational Medicine/Clin Pharm; May act as Clinical study leader (CSL.
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The Senior Service Delivery Manager manages inquiries regarding the administration of HealthEquitys products. Personal and healthcare financial literacy programs. EDUCATION:Knowledge of healthcare plans, banking, the CDHP Consumer Directed Health Plan industry or a closely related field as normally obtained through the completion of a High School Diploma / Bachelors Degree.
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This role engages clients from onboarding through ongoing service management. The compensation range describes the typical minimum or maximum base pay range for this position. Collaborate with an Account Executive on long term client strategy and growth.
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Confirms that all documentation adheres to Zelis standards regarding privacy, compliance, legal aspects, and HIPAA standards. Confirms that all documentation adheres to Zelis standards regarding privacy, compliance, legal aspects, and HIPAA standards.
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EQUIPMENT:Proficiency with business and communications software (preferably Word, Excel, PowerPoint, common Windows operating systems, and Outlook) is required. HealthEquity has a vision that by2030 we will make HSAs as wide-spread and popular as retirement accounts.
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