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Strong business and industry regulatory acumen complemented by claims adjusting knowledge, premium and medical billing familiarity, and industry best practices in risk management and fraud detection/prevention.
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The lead sterile processing tech assists Sterile Processing Department (SPD) Manager/ Supervisor in overseeing compliance with regulatory considerations. Under supervision of the SPD (Sterile Processing Department) Supervisor / Manager , the Lead Sterile Processing Technician will serve as a shift lead and will run a shift independently when supervisors are not present.
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Certification through HSPA (Healthcare Sterile Processing Association) and Materials Management) (CRCST) or CBSPD (Certification Board for Sterile Processing and Distribution) (CSPDT) The Lead Sterile Processing Technician position is for an experienced Certified Sterile Processing Technician.
$18.007 - $24.47Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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The Executive Director, Regulatory and Enterprise Risk Management works with legal and regulatory risk analysis and claims/litigation activities, self-insurance, and excess insurance programs, as well as other related legal and regulatory issues related to the UHealth clinical enterprise.
ExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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Working knowledge of PCs and word processing and data management software including Microsoft Office Suite, SharePoint, SmartSheet, Electronic Data Capture (EDC) and Electronic Medical Records (EMR.
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Work all assigned billing edits related to cardiac cath and interventional radiology technical claims within nThrive claims and Charge Capture Audit (CCA). For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as company and applicable professional standards.
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Administers warranty claims, reviews warranty policy adjustments, understands and applies warranty guidelines, ensures correct processing of claims, and communicates warranty information and clarifications to customers.
$225,000 - $250,000 a yearFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Participates in the coordination and completion of multidisciplinary efforts in regard to regulatory preparedness and completion of applications (e.g. Hospital Accreditation and Licensure, CMS Database Forms, ICM completion, measurement of success data, DPH/DOH or CMS corrective action plans, and clinical charter teams.
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The company also provides managed care services, including claims processing, stop-loss insurance, provider network access, medical management, care management and wellness programs, actuarial services, and other administrative services.
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Experience with Healthcare data, e.g., clinical trial data, electronic medical records, and insurance claims; or Bioscience’s data, e.g., protein or small molecule data, or bioinformatics; or Biopharmaceutical manufacturing.
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As a dedicated Sr Auto Adjuster, you will adjust highly complex auto insurance claims presented by or against our members to include the end-to-end claims process and settling claims in compliance with state laws and regulations.
$51,840 a yearFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Strong understanding of revenue cycle management processes, including charge capture, claims processing, and reimbursement methodologies. Epic certification in Resolute Hospital Billing (HB) required, additional certifications preferred (i.e. Professional Billing, Claims, Benefits Engine.
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They ensure patient and team member safety and adherence to regulatory agency recommendations related to the sterile processing area. Requires one national certification (CRCST,CSPDT,CFER or CST) and a second national certification related to central service or sterile processing (Examples: CIS; CSIP; CFER; CST; CHMM; CHL.
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Submitting permit applications via online portals for Client projects to regulatory agencies (DDOT, DOB, DOEE, etc. InterAgency is seeking a full time Regulatory Compliance Specialist to support a large civil infrastructure program in Washington DC, on permitting and regulatory compliance.
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Experience working with or knowledge of natural resource management agencies and regulatory agencies (e.g., Federal Energy Regulatory Commission, U.S. Army Corps of Engineers, etc.) Assist with the preparation of technical project documents, including, but not limited to: writing, word processing, building tables and spreadsheets, tabulating and manipulating data, producing hard copy documents, completing air and erosion control engineering calculations commensurate with the candidate’s background.
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regulatory claims processing jobs Company: Metroplus Health Plan
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