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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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Cigna-HealthSpring is contracted with Medicare for PDP plans, HMO and PPO plans in select states, and with select State Medicaid programs. – Wellcare is the Medicare brand for Centene Corporation, an HMO, PPO, PFFS, PDP plan with a Medicare contract, and is an approved Part D Sponsor.
ExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
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The Medicare Compliance Analyst & Support Specialist position is an essential role within Fallon Health's Medicare compliance program and includes activities such as the collection and review of data universes for accuracy to protocols, data analysis to identify risks and trends, developing data visualization and dashboards to portray information to Fallon Health Leadership up to the Audit & Compliance Committee of the Board.
Full-timeRemoteExpandApply NowActive JobUpdated 28 days ago - UpvoteDownvoteShare Job
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A Compliance Analyst contributes to AHF by maintaining compliance with the 340B Program regulations and guidelines. The Compliance Analyst will work as a part of a close knit team to identify updates in 340B Program regulations and guidelines and bring to the Executive Team for action.
$57,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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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), in addition to collaboration with, inter-departments to ensure member needs are met while simultaneously building strong peer relationships.
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Classification: work with the senior trade compliance manager on classification of all relevant items. This role is reporting to the Senior Trade Compliance Manager. The Trade Compliance Specialist focuses on import and export compliance management, including but not limited to product classification, SLI’s, duty drawback, export screening, audit and recordkeeping.
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Assist with projects involving SPCC, stormwater, NPDES, hazardous waste, hazardous materials, EMS, air quality and other environmental regulatory compliance services including regulatory research, compliance planning and auditing, creating spreadsheets, and compiling and writing reports and other documents.
$70,000 - $84,000 a yearExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Lead NCATS Cybersecurity compliance efforts to follow the Risk Management Framework (RMF). · Ensure on time delivery of task order deliverables for cybersecurity compliance. The Cybersecurity Compliance Lead will support day-to-day and project-based security activities, POA&M remediations, vulnerabilities impact, and remediation process for the on-premises and cloud environments.
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Implement, update, and maintain quarterly audit process to assess compliance with contractual terms related to participation requirements with minority group business enterprises (MWBE). Oversee the production of monthly Power BI newsletter ("Compliance In Action") and its distribution to company leaders.
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In addition, the incumbent assists in the maintaining the records required by all authorities having jurisdiction as well as ensures UW Health compliance with all emergency management, life safety, and environment of care standards of The Joint Commission (TJC) and equivalent Center for Medicare and Medicaid (CMS) conditions of participation.
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Must have minimum 3 years previous experience as an Affordable Housing Compliance Specialist, compliance for LIHTC, HUD, LURA and bond regulations, and property staff training on Yardi data entry and compliance.
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Audit operational areas and delegated vendors for compliance and ensure Jefferson Health Plans (JHP) is meeting applicable federal and state laws and regulations, and contractual requirements as set forth by all regulatory entities including but not limited to Pennsylvania State regulatory agencies (DHS, DOH and PID) and Centers for Medicare and Medicaid (CMS.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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As a Medicare Sales Consultant you will attend a 40-hour, instructor-led learning session to prepare for passing the state health exam. Medicare Sales Consultant (College/Military) Fully understand, abide by and stay current with all Center for Medicare and Medicaid Services (CMS) rules and regulations as they pertain to duties assigned Work with internal supervisors, managers, training staff, and customer service representatives Performs other related duties as assigned Base pay + uncapped commission potentials along with competitive benefits for yourself & your family.
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The Assistant General Counsel I supports and reports to the Chief Legal Officer and provides legal advice on a wide variety of matters related to Community's Medicare, Medicaid and Marketplace programs and operations including contracting, quality, utilization management, network management, privacy and security, litigation, fraud, waste and abuse, and contractual and regulatory compliance.
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Administers MercyOne’s CMS-based Shared Savings/ACO Programs (e.g., Medicare Shared Savings Program (MSSP. She/he will work collaboratively with the MercyOne Operations Team to provide oversight to PHSO colleagues related to compliance and contracting, among other functions.
Full-timeExpandApply NowActive JobUpdated 9 days ago
medicare compliance jobs Title: compliance Company: Metroplus Health Plan
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