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The Senior DME billing code compliance and appeals specialist will play a crucial role in ensuring that our DME product complies with the billing codes and regulations set by Medicare and all federally funded payers.
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The Regulatory and Audit Compliance Specialist (“Specialist”) is responsible for developing and maintaining a risk-based quality auditing program for the New York Blood Center Enterprise division.
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We are recruiting for a RN Registered Nurse, Quality Compliance & MRR Audit Specialist - Denver Health Medical Plan to join our team! Knowledge of Medicare, Medicaid, NCQA and CMS contracting standards preferred.
$71,668 - $107,502 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The Coding Compliance Specialist performs reviews by validating accuracy of the coding billed in relation to the medical documentation across Hackensack Meridian Health (HMH) network. Must have thorough understanding of ICD-10 Coding; Healthcare Common Procedure Coding System (HCPCS) / Current Procedural Terminology (CPT) coding systems; Medicare Outpatient Prospective Payment System (OPPS), and Ambulatory Payment Classification (APC.
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Minimum Experience: Three to six months of data entry experience with at least one year of experience handling patient information and charts, preferably in an oncology unit with demonstrated knowledge of Medicare regulations, billing compliance, and/or coding issues.
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With strong organizational skills, the Compliance Specialist assists the Compliance Officer in achieving the goals and objectives; identifies and resolves a variety of issues related to regulatory issues; maintains basic commercial regulatory files; develops and facilitates marketing materials; and prepares and submits Medicare/commercial marketing materials to federal and state regulators.
ExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
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The Senior Regulatory and Audit Compliance Specialist (Specialist) is responsible for regulatory and accreditation activities related to cGxP manufacturing at New York Blood Center Enterprises (NYBCe.
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Utilizes and understands the Medicare Coverage Analysis (MCA), as well as sponsor contract language to determine intricacies of research and routine care charges. HHRI IRB Compliance. Miscellaneous projects as assigned by the lead research compliance team members and director of compliance.
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Assist Compliance Manager with updates of documents required by accrediting organization, Medicare, and Commercial plans. Assist Compliance Manager in preparing offices for accreditation visits.
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The Compliance Specialist is responsible for assisting the management of the compliance program for the Össur Americas Business Units. Basic understanding of DOJ enforcement actions, corporate compliance guidance and corporate integrity agreements.
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The candidate must be familiar with current Texas Medicaid regulations, the Texas Department of Health and Human Services, Texas Department of Insurance (TDI) regulations, the Office of Inspector General (OIG) Compliance Plan, the Centers for Medicare and Medicaid Services (CMS) and should also be familiar with health plan documents such as Summaries of Benefits and Coverage, Schedules of Benefits and Certificates of Coverage.
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Basic understanding of medicare, medicaid and private payor relationships and reimbursement issues such as medical necessity, local coverage decisions and claw back provisions. Oversees auditing and monitoring of compliance with relevant laws, regulations, and corporate policies across the US, Canada and Mexico – the Americas.
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Customer License Compliance SpecialistCurrent NeedWe are seeking a Customer License Compliance Specialist to join our team. Desired backgrounds may include healthcare, Medicare, pharmaceuticals, biologics manufacturing, clinical research, or paralegal.
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Review requests for standard social security and Medicare tax exemptions based on immigration and student status. Review basic tax residency classifications of international faculty, staff, students, guests and vendors and audit for compliance.
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In this role, the successful candidate Responsible for participation in regulatory compliance initiatives that focus on Rehabilitation care delivery and ensures compliance with the regulatory mandates of The Joint Commission (TJC), Commission on Accreditation of Rehabilitation Facilities (CARF), Centers for Medicare & Medicaid Services (CMS), New York State Department of Health (NYS-DOH) and other regulatory agencies and accrediting bodies pertinent to the areas of responsibilities.
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medicare compliance jobs Title: compliance specialist
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