Medicare compliance jobs in Plainview, New YorkCreate job alerts

Work Schedule: Full-time/40 Hours Position Type: On-site Branch Location: Westbury, NY This is NOT a remote or work-from-home position. This position requires you to sit on-site at our Westbury, NY branch location. The RN Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel. This role is a focused on both home health clinical quality assurance and home health clinical operations initiatives. * Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed. * Conducts/delegates the assessment and reassessment of patients, including updating of care plans and interpreting patient needs, while adhering to Company, physician, and/or health facility procedures/policies. * Manages the assignment of caregivers. * Responsible for and oversees the delivery of care to all patients served by the location. Receives case referrals. Reviews available patient information related to the case, including disciplines required, to determine home health or hospice needs. Accountable to ensure patients meet admission criteria and make the decision to admit patients to service. Assigns appropriate clinicians to a case, as needed. * Instructs and guides clinicians to promote more effective performance and delivery of quality home care services, and is available at all times during operating hours to assist clinicians as appropriate. * Assists clinicians in establishing immediate and long-term therapeutic goals, in setting priorities, and in developing patient Plan of Care (POC). * Monitors cases to ensure documentation is in compliance with regulatory agencies and requirements of third-party payers. Ensures final audits/billing are completed timely and in compliance with Medicare regulations. * Coordinates communication between team members/attending physicians/caregivers to ensure the appropriateness of care and outcome planning. * Works in conjunction with the Branch Director and Company Finance Department to establish location’s revenue and budget goals. * Participates in sales and marketing initiatives. * Supervises all clinical employees assigned to a specific location. Responsible for the overall direction, coordination, and evaluation of the location. Carries out supervisory responsibilities in accordance with Company policies and procedures. * Handles necessary employee corrective action and discipline issues fairly and objectively, in consultation with the Human Resources Department and the Executive Director/Director of Operations. * Participates in the interviewing, hiring, training, and development of direct care clinicians. Evaluates their performance relative to job goals and requirements. Coaches staff and recommends in-service education programs, when needed. Ensures adherence to internal policies and standards. * Assesses staff education needs based on own the review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts regular staff education as needed. * Analyzes situations, identifies problems, identifies and evaluates alternative courses of action through the utilization of Performance Improvement principles. * Responsible for review of the appropriate number of Case Managers and clinical staff documentation to include starts-of-care, resumption-of-cares, and re-certifications, for appropriateness of care, delivery, and documentation requirements. * Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance review and outcomes of care analysis to determine efficiency, the efficacy of case management system as well as any other systems and process. Competently performs patient care assignments and staff management activities. * Provides direct patient care on an infrequent basis and only in times of emergency. * Acts as Branch Director in his/her absence. * Interprets Company standards and Company policies and procedures to ensure compliance with external regulatory authorities and ensures that caregiver clinical documentation meets internal standards. * Participates in performance improvement activities, maintains ongoing clinical knowledge through internal and external training programs. Provides interpretation of knowledge and direction to staff. * Maintains relationships with referral/community sources. Participates in professional organizations and conducts care-related programs. * Performs other related duties as assigned or requested. Required Experience/Skills: * Graduate of an accredited School of Nursing. * Current state license as a Registered Nurse. * Proof of current CPR. * Valid driver’s license, auto insurance and reliable transportation. * Two years as a Registered Nurse with at least one-year of management experience in a home health, hospice or equivalent environment. * Certified Home health Agency experience is required (NY state requirement) or four years' CHHA experience and six credit hours toward BSN. * Management and people leadership experience, preferred. * OASIS experience, required. OASIS certification (HCS-O, COQS, and/or COS-C), preferred. * Homecare Homebase (HCHB) experience, preferred. * CMS PDGM billing knowledge and/or experience, preferred. Additional Information * Normal Hours of Operation: M-F / 8a-5p (ET) * On-Call Expectation: Rotating on-call shift. * Branch Size: 170 Census (4 STAR rating) * Annual Bonus: Eligible for the annual incentive bonus which has pay-outs both quarterly and annually. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $92,600 - $127,400 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers – all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

" \n Licensed Mental Health Therapist (LMHT)\n \n Wage: Up to $121 an hour \n \n \n \n \n Licensed Mental Health Therapist — Are you ready to launch or expand your private practice? Headway is here to help you start accepting insurance with ease, increase your earnings with higher rates, and start taking covered clients sooner. It’s all on one free-to-use platform, no commitment required. \n \n About you \n ● You’re a fully-licensed Mental Health Therapist at a Master’s level or above with LMHC, LPCMH, LIMHP, LMFT, LMFTS, LCMFT, LPC, LPCC, LCPC, LCPCS, LPCC-S, LCSW, LICSW, or LCSCW licensure (accepted on a state by state basis), a valid NPI number, and malpractice insurance. \n ● You’re ready to launch a private practice, or grow your existing business by taking insurance. \n \n About Headway \n Your expertise changes lives. Taking insurance makes it accessible to those who need it most. Every mental health provider who goes in-network with Headway supports people who’d otherwise be forced to choose between paying out of pocket, or not getting care at all. We make that process seamless — empowering you to accept insurance with ease, so you can do what you do best. So far, we’ve helped over 50,000 providers grow their practices, reaching countless people in need. \n \n How Headway supports providers \n \n How Headway supports your clients \n ● Increased access: Headway makes it easier for your clients to get the care they need at a price they can afford through insurance. \n ● Instant verification: Clients can easily check their insurance status and get the care they need without disruption. \n \n \n Please note: At this time, Headway can’t support mental health professionals that aren’t fully licensed. If your application was rejected for incomplete licensure, you’re welcome to reapply once you have a valid license. \n \n \n \n \n \n \n \n "

Licensed Mental Health Therapist (LMHT) Wage: Between $120-$131 an hour Licensed Mental Health Therapist — Are you ready to launch or expand your private practice? Headway is here to help you start accepting insurance with ease, increase your earnings with higher rates, and start taking covered clients sooner. It's all on one free-to-use platform, no commitment required. About you ? You're a fully-licensed Mental Health Therapist at a Master's level or above with LMHC, LPCMH, LIMHP, LMFT, LMFTS, LCMFT, LPC, LPCC, LCPC, LCPCS, LPCC-S, LCSW, LICSW, or LCSCW licensure (accepted on a state by state basis), a valid NPI number, and malpractice insurance. ? You're ready to launch a private practice, or grow your existing business by taking insurance. About Headway Your expertise changes lives. Taking insurance makes it accessible to those who need it most. Every mental health provider who goes in-network with Headway supports people who'd otherwise be forced to choose between paying out of pocket, or not getting care at all. We make that process seamless — empowering you to accept insurance with ease, so you can do what you do best. So far, we've helped over 50,000 providers grow their practices, reaching countless people in need. How Headway supports providers Start taking insurance, stress-free: Get credentialed for free in multiple states in as little as 30 days and start seeing covered clients sooner. Built-in compliance Stay compliant from day one with audit support and ongoing resources. Expansive coverage: Work with the plans that most clients use, including Medicare Advantage and Medicaid. Increase your earnings: Secure higher rates with top insurance plans through access to our nationwide insurance network. Dependable payments: Build stability in your practice with predictable bi-weekly payments you can count on. Built-in EHR features Manage your practice in one place with real-time scheduling, secure client messaging, end-to-end documentation templates, built-in assessments, and more. Free continuing education Nurture your long-term professional goals and earn CEUs with complimentary courses on Headway Academy. How Headway supports your clients Increased access: Headway makes it easier for your clients to get the care they need at a price they can afford through insurance. Instant verification: Clients can easily check their insurance status and get the care they need without disruption. Please note: At this time, Headway can't support mental health professionals that aren't fully licensed. If your application was rejected for incomplete licensure, you're welcome to reapply once you have a valid license.

Job Description Insurance AR Follow-Up Representative Location: Melville, NY Pay Rate: $23–$26/hour Job Summary Are you detail-oriented and analytical with experience in medical billing or hospital revenue cycle operations? A healthcare organization in Melville, NY is seeking an Insurance AR Follow-Up Representative (Third-Party Follow-Up Specialist) to manage insurance accounts, ensure accurate reimbursements, and support revenue collection. This role offers hands-on training, a mission-driven team environment, and a critical function in maintaining billing accuracy. Key Responsibilities Insurance Follow-Up & Collections • Manage follow-up activities on billed accounts to ensure timely payment, • Contact third-party payers via portals, phone, or correspondence to obtain claim status, • Analyze EOBs and remittances to verify payments or appeal denials, • Submit clean primary and secondary claims through Epic, • Verify insurance coverage and update accounts accordingly, • Analyze credit balances and process necessary refunds or voids, • Accurately document follow-up activities in account notes, • Communicate effectively with internal teams and patients regarding account inquiries, • Stay current on Medicare, Medicaid, and private insurance billing rules, • Process 30–40 accounts daily independently, • High School diploma or GED required; college degree preferred, • Certified Medical Coder (CMC) a plus, • 1–2 years of healthcare billing or AR follow-up experience (hospital or professional billing preferred), • Knowledge of third-party payer rules, denials, and reimbursement processes, • Strong math, analytical, and communication skills, • Proficiency in Epic and Microsoft Office; typing speed of 35+ wpmCompany DescriptionThe Bachrach Group (TBG) is a New York-based staffing and recruiting agency founded in 1974 by Richard Bachrach. The agency specializes in facilitating placements for professionals across various industries on a nationwide scale. TBG's overarching mission is to deliver tailored staffing solutions to its client base while simultaneously providing job seekers with career prospects. The company relies on its team of recruiters, who leverage their industry knowledge and networks to connect employers with top talent. TBG provides a comprehensive range of staffing services, including direct hire, temporary staffing, Recruitment Process Outsourcing (RPO), and contract staffing. The agency has consistently achieved notable rankings in Crain's lists, ranking as the largest search firm in NYC since 2020.The Bachrach Group (TBG) is a New York-based staffing and recruiting agency founded in 1974 by Richard Bachrach. The agency specializes in facilitating placements for professionals across various industries on a nationwide scale. TBG's overarching mission is to deliver tailored staffing solutions to its client base while simultaneously providing job seekers with career prospects. The company relies on its team of recruiters, who leverage their industry knowledge and networks to connect employers with top talent. TBG provides a comprehensive range of staffing services, including direct hire, temporary staffing, Recruitment Process Outsourcing (RPO), and contract staffing. The agency has consistently achieved notable rankings in Crain's lists, ranking as the largest search firm in NYC since 2020.

Job Description Physician Billing Specialist (Epic | Medicare/Medicaid | Insurance Follow-Up) Experience: 1–2 Years | Healthcare Revenue Cycle Job Summary We are seeking a detail-oriented Physician Billing Specialist with hands-on experience in insurance billing, claims follow-up, and denial management. This role is ideal for someone with strong knowledge of Medicare/Medicaid, medical insurance coverages, and Epic EMR who thrives in a fast-paced healthcare environment. Key Responsibilities • Submit and follow up on primary and secondary insurance claims, • Perform insurance carrier follow-up on outstanding and denied claims, • Analyze EOBs/Remittance Advice and submit appeals for denials or underpayments, • Verify patient insurance eligibility, benefits, and demographic accuracy, • Determine and communicate patient financial responsibility, • Update patient accounts and insurance information in Epic, • Ensure compliance with HIPAA and billing regulations, • Conduct outbound calls to insurance companies regarding claim status, • High School Diploma or GED required, • 1–2 years of physician billing experience, including carrier follow-up, • Strong knowledge of Medicare, Medicaid, and commercial insurance, • Experience with Epic EMR or similar medical billing systems (preferred), • Working knowledge of HIPAA compliance, • Excellent communication, analytical, and organizational skills, • Ability to multitask, work independently, and meet deadlines, • Computer proficiency and attention to detail

Job DescriptionCompany Description We connect growth-minded companies with high-impact professionals who drive real results. Whether you're building a team or building a career, our approach is precise, people-first, and built for long-term success. We don’t do buzzwords—we do outcomes. Job Description The Opportunity: We are representing a premier healthcare system in New York looking for a Revenue Recovery Specialist. This is a critical role within the Physician Billing department where your expertise in navigating the complexities of the revenue cycle directly impacts the organization’s financial health. If you are a "claims detective" who loves resolving denials and securing payments, this is the career move for you. What You’ll Be Doing: * Claims Resolution: Perform rigorous follow-up on all outstanding physician billing accounts according to established policies. Denial Management: Analyze Remittance/EOBs and submit strategic appeals for denials or underpayments. * Payer Navigation: Place outbound calls to insurance carriers to verify coverage and resolve claim status discrepancies. * System Optimization: Utilize the Epic System to accurately update patient accounts and initiate billing Qualifications What We’re Looking For: • Experience: 1–2 years of prior Physician Billing experience, specifically in carrier follow-up., • Technical Knowledge: Strong understanding of Medicare/Medicaid regulations and medical insurance coverages., • Software: Epic experience is highly preferred., • Compliance: Thorough knowledge of HIPAA regulations. Additional Information Why Join This Team? * Stable Industry: Secure a role within an essential healthcare infrastructure. Professional Growth: Work independently while receiving clear direction in a high-performing billing environment. * Note: This is a full-time position located in New York. Candidates must have a High School Diploma or GED. For immediate consideration, apply directly or text/call 407.436.9060 to schedule an interview.

Essential Functions: • Manage complex projects or processes with general oversight • Oversee the generation, quality, and timeliness of proposal submittals and status reporting internally and externally • Communicate within and outside of own function to gain cooperation on operational proces

In compliance with pay transparency requirements, the salary range for this role in Colorado state and New York state is $75,000-$139,000. Monitor program activities to ensure compliance with product specifications, performance requirements, schedules, and cost commitments.

Call Center / Remote] - Anywhere in U.Competitive pay / Medical, dental & vision / 401k / PTO - As a Customer Service Rep at Planet Home Lending, you will: Respond to borrower inbound calls concerning their account, ensuring high quality service and adhering to productivity and regulatory requiremen

Seeking participants for Focus Group and market research studies.Work part-time from home and earn up to $750 per week.Register to see if you are eligible.Customer service representative agent experience not required.Remote Work From Home Customer Service Representative Agent - Part Time Market Rese

Seeking participants for Focus Group and market research studies.Work part-time from home and earn up to $750 per week.Register to see if you are eligible.Administrative Assistant admin experience not required.Remote Work From Home Administrative Assistant Admin - Part Time Market Research Panelists

Customer Support / Remote] - Anywhere in U.Medical, dental & vision / 401k - As a Customer Service Rep at DGI Supply, you will: Handle customer and sales interactions via phone, email and tickets within the Customer Care Box; Process requests for quotations, order entry and product questions from cu

Bank Clothiers - 140 Smith Street, Farmingdale, NY, United States, 11735 [Customer Service Representative] As a Customer Service Representative at JoS.Bank Clothiers, you'll: Handle and accurately follow standard operating procedures for all customer purchases, returns, exchanges, store credits and

Customer Support / Remote] - Anywhere in U.Medical, dental & vision / PTO / Paid training - As a Customer Service Rep at Assurant, you will: Handle inbound customer calls and/or e-mails with empathy and professionalism; Resolve issues, answer questions, and provide proactive solutions; Document inte

Landlord Tenant Corporation Hiring for a Full Time Administrative Assistant for a new office on Long Island.This Jobot Job is hosted by: Adam Cejnowski.Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume.Salary: $50,000 - $65,000 per year.Growing Landlor