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The Compliance Senior Manager also has experience in general healthcare compliance matters, particularly as they relate to federal Medicare, Medicaid, Fraud, Waste and Abuse laws, including but not limited to OIG, Stark, and Anti-Kickback Statutes and all other applicable regulations, including the development of general compliance policies and procedures, training, and auditing.
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Healthcare Fraud Investigator (AHFI), Health Care Anti-Fraud Associate (HCAFA), Certified Insurance Fraud Investigator (CIFI), Certified Financial Crimes Investigator (CFCI), Certified Fraud Examiner (CFE), Certified in Healthcare Compliance (CHC), or similar certifications in medical auditing or clinical coding such as CPC, CEMA, or CPMA preferred.
$106,200 - $242,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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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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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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Categories: Healthcare/Medical Professional Level, Management/Supervisor, Healthcare/Nursing/Investigations/Compliance. Medicaid and Medicare Federal Regulations, State Statute, Rules, and Policies applicable to AHCCCS programs.
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CHC is looking for passionate, qualified Youth Engagement Specialists who are skilled in supporting youth who have experienced homelessness and human trafficking, have experienced trauma, identify as LGBTQ+, are gender non-conforming and/or who often face multiple issues and have complex needs.
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The VP, Compliance is responsible for leading the Fintech line of business compliance management program for cards and loans to ensure compliance with federal, state, and local regulation, and partner relationships.
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Softworld is currently recruiting for a Sr. Compliance Specialist to work in hybrid model in Washington, MI. The ideal candidate should possess a minimum of 5 years of natural gas operations, maintenance, or support experience, preferably with additional hazardous liquid experience.
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Obtain and/or ensures compliance with all environmental permits necessary for the operation of sand and gravel mining and processing sites,asphalt plants and other related operations. Perform environmental compliance audits at various plant and facility sites to ensure environmental conformity with local, state and federal ordinances and regulations.
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A well established bank is looking to add on a Senior Compliance Specialist. Overseeing Bank Secrecy Act (BSA), Anti-Money Laundering (AML), and Office of Foreign Assets Control (OFAC) compliance activities, including monitoring, investigation, and reporting of suspicious activities.
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Are in compliance with regulatory agencies, including but not limited to, Covered California, the Centers for Medicare and Medicaid Services (CMS), the California Department of Health Care Services (DHCS), and the California Department of Managed Health Care (DMHC), i.
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Must have minimum 3 years previous experience as an Affordable Housing Compliance Specialist, The Compliance Specialist reports to the Compliance Manager and is responsible for assisting with all property.
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Accountable for developing prospective and retrospective risk adjustment review processes that are in compliance with all government regulations to drive accurate coding for Florida Blue Medicare in support of accurate risk capture; efforts will serve in partnership with FBM Stars and HEDIS quality programs.
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AECOM is actively seeking a NEPA Compliance Specialist (Water) to join our Environmental Planning Group. + 8+ years of relevant experience with NEPA compliance especially with water resources planning work; or environmental permitting and technical report writing.
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In particular, the AVP will play a critical leadership role in the development of processes relating to Medicare risk adjustment, documentation, and in-home wellness assessments (in partnership with Humana's Medicare Risk Adjustment team, as well as with external strategic partners), given the importance of these areas to the delivery of value-based care.
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medicare compliance chc jobs Title: compliance specialist Company: Metroplus Health Plan
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