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Experience with compliance auditing, facility and physician coding/billing practices, PPS systems of payment (e.g. DRG, APC, APL, HHRG, CMG) and Medicare provider-based rules preferred.
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The successful candidate will have a deep understanding of the DME supply industry and Medicare billing requirements including but not limited to: Medicare coverage policies, HCPC Level II Codes, Medicare billing guidelines, Medical documentation, Appeal process, Fraud and Abuse regulations, Communication with educating patients and providers, and being an expert in Compliance and auditing.
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The Sr. QA Specialist will be responsible for the auditing and oversight of all QA compliance GxP activities within their assigned area. QA compliance manager, quality assurance, QA, management, GxP, GCP, GLP, GMP, auditing, clinical research, regulatory, inspections, sponsor audits, stakeholder management, process improvement, travel, investigator site audits, TMF audits, QMS, communication, remote, united states, US.
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Compliance Auditing Specialist is responsible for ensuring that properties are maintaining program requirements set by the IRS, states, local governments and other entities to maintain compliance for affordable communities within their portfolio.
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Relevant education may include privacy, accounting, compliance, auditing, IT security, risk assessment, or closely related fields. Six (6) years of professional experience in privacy, accounting, compliance, auditing, IT security, risk assessment, or closely related fields.
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Berkshire Hathaway Specialty Insurance (BHSI) has an exciting opportunity for a new team member to join their Boston based IT Audit/Compliance team as an IT Compliance Analyst. In this newly created role, the IT Compliance Analyst will take an active role in the execution of our IT audit and compliance framework, while collaborating closely with both internal and external partners.
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Job Title/High Level Position Summary:Senior Information Security Engineer – SOX Compliance Lead is responsible for the planning, design and build of security architectures; oversees the implementation of network and computer security and ensures compliance with corporate cybersecurity policies and procedures.
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The ideal candidate will have a strong understanding of regulatory requirements in the cryptocurrency space and will lead a team of compliance professionals to ensure adherence to these standards.
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Master's degree from an accredited university in Business or Public Administration, Accounting, or a closely related field; Certification as an Internal Auditor, Certified Fraud Examiner, and/or Certified Fraud Specialist; Experience with continuous auditing; information technology and security audits; and/or performing data mining and analysis with data analytic tools; Five years' experience in internal auditing.
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The Coding/Auditing Specialist position conducts quality assurance activities to ensure the accuracy and integrity of risk adjustment data submitted to the Centers for Medicare & Medicaid Services (CMS) and Department of Health Services (DHS); identifies deficiencies and provides management with an analysis of outcomes and tools for improving accuracy in coding.
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The Prevention of Sexual Abuse (PSA) Compliance Manager is responsible for the preventative education, detection, management, reporting, implementation, and compliance with the HHS Interim Final Rule (IRF): Standards to Prevent, Detect, and Respond to Sexual Abuse and Sexual Harassment Involving Unaccompanied Children (45 C.F.R. Part 411) in order to prevent and respond to sexual abuse and harassment involving Unaccompanied Children (UC.
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Is prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and maintain PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator.
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About NYC Health + Hospitals MetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
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The Compliance Audit III will oversee compliance auditing and monitoring initiatives to assess and identify compliance risks with Federal and State regulatory and contractual requirements.
$38.37 - $48.93 an hourFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Under the direction of the Compliance Internal Auditor, this position is responsible for conducting auditing and monitoring activities encompassing revenue cycle, finance, and other business practices including compliance with conditions of participation, coding and billing, financial and business controls, and compliance with applicable laws and regulations.
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medicare compliance auditing jobs Title: compliance specialist Company: Metroplus Health Plan
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