Are you a business? Hire medicare compliance candidates in New York, NY
The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plan...
Minimum QualificationsA Bachelor’s degree requiredAt least 4 years of Managed Care experience including thorough knowledge of Medicare, federal, and state regulationsPrior experience required in quality improvement and compliance oversight1-3 years of Compliance/Regulatory Affairs experienceProje...
Position OverviewReporting to the Senior Manager of Medicare Operations, the Product Specialist, Integrated Products will play a critical role in supporting product excellence, implementation, and regulatory compliance for the Integrated Medicare lines of business. As a wholly-owned subsidiary of...
Join our team and help ensure smooth and accurate billing processes that support quality healthcare delivery! As a Medical Billing Clerk, you will play a key role in the Revenue/Billing department. Your work will directly impact the processing of claims and reimbursements, ensuring that healthca...
Innova Solutions is immediately hiring for Clinical Quality Reviewer. The primary function of the Clinical Quality Reviewer is to assess and audit medical charts for compliance with a focus on HEDIS, QARR, Medicare Advantage Star measures and quality improvement activities. Perform clinical audit...
Responsibilities of this Medical Director role are related to Medicare Appeals. Provide direct support to appeal nurses and dedicated Medicare part D pharmacists; supervision and participation in the Second Look Review (SLR) process. Collaborative work with Medicare Quality and Compliance on an o...
Insure high quality, cost-effective care and services for Elderplan members through support of professional Care Management and/or Clinical Service activities. The position supports all aspects of care coordination for our Medicare, Medicaid, and/or dual product members in compliance with all dep...
The Director of Medicare Product serves as the subject matter expert and resource for all departments and intergovernmental, federal regulatory agencies related to various Medicare products and operations to ensure compliance. Significant and demonstrable experience with Medicare, Medicaid, Dual ...
A healthcare network in the New York City is actively seeking Regional Medical Director to join their growing staff at an outpatient clinic in Manhattan. Job Responsibilities: Lead medical care and oversee interdisciplinary teams across Diagnostic and Treatment Centers Ensure delivery of quality ...
We are recruiting for a Consultant to join our Health Compliance practice. The Role: The Health Compliance Consultant (lawyer) reports to the Deputy Director of the Health Compliance Practice. They will perform as a regulatory expert and Companywide technical resource on health benefit plan desi...
Monitor monthly budget of visits, labor, and clinical supplies * Monitor documentation audits, Medicare compliance and patients approaching MMR cap * WebPT schedule review weekly * Monitor staff ...
Comprehensive Knowledge - Understanding Worker's Compensation guidelines, Medicare coding, and compliance obligations. * Software - You are proficient with Microsoft Office: Excel, Word, PowerPoint ...
Chief Medical Officer - Medicaid. Works with Compliance and Special Investigation Unit on issues related to Fraud, Waste, and Abuse of Medicare/Medicaid services. Demonstrated strong knowledge of Medicare and Medicaid regulatory and reporting requirements required. ...
Review bills for accuracy and completeness and obtain any missing information.Knowledge of insurance guidelines, especially Medicare and state Medicaid.Follow up on unpaid claims within standard billing cycle timeframe.Check each insurance payment for accuracy and compliance with contract.Handlin...
Customer Service Representative. As a Customer Service Representative, you will be the first point of contact for customers seeking assistance, providing exceptional service and resolving inquiries with professionalism and efficiency.
As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. The Sales Quality and Compliance Specialist reports to the Chief Growth Offi...
Immediate opening for Customer Service/Operations Manager familiar with import operations.Remote position based in New York/New Jersey.Minimum 5 years management experience in import operations.Proven track record of leading an operations team.Familiar with day to day operations.Dealing with ship...
Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies.We guarantee 15-25 hours per week with an hourly pay of between $25 / hr.There is no payment required in order to apply or to work as an In-Home Usage Tester.Y...
Market research companies that partner with us will use questionnaires to identify and target certain types of consumers, to ensure that the right participants are engaged and to achieve the representative sample needed. A paid Product Tester position is perfect for those looking for an entry-lev...
A paid Product Tester position is perfect for those looking for an entry-level opportunity, flexible or seasonal work, temporary work or part-time work. Telecommute (you can work from home, work or school). We are a consulting firm that specializes in product testing and product development work....
