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Requires five (5) years’ experience with knowledge of laws and regulations pertaining to health care, regulatory compliance, hospital and/or physician billing and information systems, Medicare/Medicaid and financial reimbursement systems, and HIPAA Privacy and Security issues.
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The Bureau of Medicaid Program Integrity (MPI) does this specifically through audits and investigations of healthcare providers, including managed care plans, suspected of engaging in fraudulent or abusive behavior, as well as overpayment recoveries, administrative sanctions, and the referral of suspected fraud or other criminal violations for law enforcement investigation.
$32,760 - $40,413.87 a yearFull-timeExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Well versed in current healthcare compliance issues, OIG enforcement activities, and other applicableregulations such as HIPAA, licensure requirements, and quality standards. Working knowledge of management of an effective ethics and compliance program, including auditing,training, monitoring, conducting and documenting investigations, addressing violations and monitoringcorrective actions.
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Licensure or other certifications: Certified Medical Assistant, LPN, or other similar clinical licensure or Certified Professional In Healthcare Risk Management (CPHRM), Certified Professional in Healthcare Quality (CPHQ), or Certified Professional in Patient Safety (CPPS), or obtained within 1 year of hire.
ExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Experience in Medical Billing, Accounts Receivables, and/or Collections within a healthcare or insurance environment is preferred. Follows all Medicare, Medicaid, and HIPAA regulations and requirements.
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Conducts medical insurance verifications and investigations for commercial and government payors. Position Summary : The Reimbursement Specialist will be responsible for billing and revenue cycle management thorough insurance benefit investigation of new referrals, assignment of collections with a variety of payers, authorization requests, and claim submissions.
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Commercial Legal Counsel: In addition to the role of lead privacy counsel, you will act as the lead commercial attorney for functional segments of the business in partnership with the Diabetes legal team – providing advice and counsel on commercial contracting, healthcare compliance and regulatory matters, M&A and strategic transactions, litigation and investigations, intellectual property and other general legal matters.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Have oversight for FDA MedSun reporting, occurrence report follow-up, performing root cause investigations and patient relations interface and resolution. Additional duties may include assisting with HIPAA and compliance activities.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Senior Healthcare Compliance Manager will act as the Subject Matter Expert in areas such as: transparency, training, communications, healthcare professional interactions, grants and donations, internal investigations, high-risk third-party vendor management, auditing and monitoring.
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Plan, organize, and execute investigations or audits utilizing document review, witness interviews and data analysis to identify, evaluate and measure potential healthcare fraud and abuse to determine valid cases for appropriate action.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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The Manager will support the Sr. Director of Corporate Compliance to ensure implementation of appropriate policies and procedures, support compliance training, conduct investigations and maintain a system of reporting and ensure the integrity of all compliance investigations, direct and coordinate internal audits, and monitor HIPAA/Patient Privacy compliance.
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At least three years of professional experience in a healthcare or research related position (e.g., corporate compliance, health information management, healthcare administration, healthcare operations, research) or of direct experience in HIPAA compliance.
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Serve as the organization’s HIPAA Privacy Officer Designing and implementing a comprehensive online privacy policy that aligns with industry best practices and regulatory requirements, ensuring transparent communication of how patient and visitor data is collected, used, and protected on our website.
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The incumbent will also monitor the Compliance Helpline and participate in the investigations process, compliance and information privacy education and assist with other special projects as needed.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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O Litigation Support: Assist in legal matters, disputes, or legal actions related to patient privacy and HIPAA compliance. Privacy Legal Counsel: Advise the business, a HIPAA covered entity with a US direct to patient business model, on privacy related matters regarding compliance, data governance, regulatory interpretation and all domestic and international privacy related regulations affecting the business.
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