Medicare Regulatory Analyst: Compliance & CMS Insight
$41.7k - $92.8kHCSC
HCSC is seeking a professional to manage and coordinate Medicare Advantage and Prescription Drug Plans. Responsibilities include handling escalated complaints, ensuring compliance with CMS regulations, and providing guidance to staff on Medicare topics. The ideal candidate will possess a bachelor's degree in business or have relevant experience in health insurance, along with strong communication skills and proficiency with data analysis and reporting tools. Competitive salary range from $41,700 to $92,800, with a comprehensive benefits package. #J-18808-Ljbffr
$167k - $202k
...services • Credit access lines available to clients/members with taxable accounts • Regularly released high-quality research and insights • Legal support so you can confidently offer services like estate planning and buy/sell agreements • Cross-sell opportunities that...SuggestedWork at office- ...ClearSky Health, based in Albuquerque, NM, is seeking an experienced medical coder to ensure coding accuracy and compliance with regulations. The successful candidate will review patient charts, assign codes using ICD-10-CM, and maintain high coding accuracy. The role...Cms
- ...account being registered has accurate information to ensure clean billing. Must possess basic knowledge of Medicare (CMS) guidelines, as well as other Compliance Regulatory guidelines applicable to Patient Access. Provide the highest level of customer service to patients/...CmsTemporary workPart timeLocal areaImmediate startShift workNight shift
- ...ClearSky Health in Albuquerque, New Mexico, is seeking a Medical Coder to ensure accurate coding of medical documents and compliance with regulatory standards. The ideal candidate will have at least three years of medical coding experience and a thorough understanding...Cms
- ...Daily Living (ADLs) and promotes client safety, comfort, independence, and dignity in the home setting while maintaining compliance with NM DOH and CMS regulations. Essential Functions Provide personal care services including bathing, grooming, oral hygiene,...Cms
- ...programs to ensure the highest standards of patient care and regulatory compliance. This role oversees clinical outcomes, coordinates quality initiatives... ...and Performance Improvement (QAPI) program in alignment with CMS, state, and organizational standards.* Develop and implement...CmsRemote work
- An insurance company is seeking a Licensed Insurance Sales Representative in Albuquerque, New Mexico. This role involves meeting sales goals, managing client relationships, and offering essential products for security and peace of mind. Candidates should have a willingness...
- ...Quality provides clinical leadership in Medical Staff Services, Regulatory Compliance, Risk Management, and Quality Management/Improvement. The... ...Responsibilities Facilitate compliance for the hospital regarding CMS, The Joint Commission, and State/Federal regulations....Cms
- ...with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and... ...diploma or G.E.D. required. * Must meet Center for Medicaid/Medicare Services (CMS)-approved state and/or national certification requirements...CmsImmediate start
$95k - $105k
...Job Description Job Description Sr. GRC Analyst About Subsplash Subsplash is an exciting award-... ...environment to ensure we stay ahead of evolving regulatory and threat landscapes. We are building an AI-first compliance function, and this role is expected to lead from...Temporary workCurrently hiringRemote workRelocation- ...healthcare regulations, including HIPAA and CMS guidelines. 5 years of clinical (direct... ...patient care documentation and ensure compliance with healthcare standards. Strong... ...advanced certifications and familiarity with regulatory frameworks enhance the supervisor's ability...CmsContract workRemote work
$15.58 - $21.19 per hour
...patient financial obligations at the time of service and ensure accounts are financially cleared. Maintain compliance with payer guidelines, Medicare (CMS) requirements, and organizational policies. Support data accuracy, productivity goals, and quality improvement...CmsFull timeTemporary workWork at officeShift workNight shiftDay shiftAfternoon shift$15.58 per hour
...patient financial obligations at the time of service and ensure accounts are financially cleared. Maintain compliance with payer guidelines, Medicare (CMS) requirements, and organizational policies. Support data accuracy, productivity goals, and quality...CmsFull timeTemporary workWork at officeLocal areaImmediate startShift workNight shiftAfternoon shift$28.71 per hour
...position requires a Bachelor's degree and experience in hospital chargemaster roles. Responsibilities include ensuring Chargemaster compliance, training hospital staff, and coordinating workflows. Applicants should have knowledge of coding principles and use of CDM...Full timeRemote work$35k - $48k
...RPMGlobal is seeking a Junior Compliance Officer in Albuquerque, NM to assist in supporting federal law enforcement clients with I-9 audits... ...data entry, compliance verification, and documentation for regulatory audits. Ideal candidates will have strong analytical skills...Work at officeRemote work$23.85 - $29.81 per hour
...Full-time Description Summary Assists the BSA Compliance Team in the daily monitoring and maintenance of the Credit Union... ...policies, procedures, and BSA best practices and keeps abreast of regulatory developments through structured training and direction from...Full timeWork experience placement$22 - $26 per hour
...with clinical teams to assign services Support Credentialing & Compliance When needed ~ Maintain and track provider credentialing and re-credentialing ~ Ensure compliance with payer and regulatory requirements ~ Prepare andsubmitcredentialing applications...Full timeWork at office- ...States of America) This position will adhere to compliance and regulatory rules as mandated by CMS, state and federal regulations, payer contracts and... ...Proficient knowledge of Coordination of benefits and the Medicare MSPQ. Must have proficient knowledge of various...CmsFull timeTemporary workWork at officeLocal areaImmediate startHome officeShift work
- ...policies, procedures, and training and in compliance with regulations set forth by the... ...standards through education regarding all ESRD regulatory and legal requirements and the practice... ...as defined by Center for Medicaid/Medicare (CMS)All appropriate state licensure, education...CmsLocal areaImmediate start
- ...Connie Health Medicare Sales Representative Connie Health is a... ...healthcare through data-driven insights and personalized guidance. We... ...meeting sales targets, adhering to compliance standards, and providing a... ...progress Stay current on CMS regulations, HIPAA policies,...CmsLocal areaRemote work
$18.33 per hour
...maintains tickler systems to ensure timely processing and compliance with regulatory and accreditation standards, while keeping credentialing database... ...serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial...Full timeTemporary workLocal areaImmediate startShift work- Senior Credentialing Specialist Basic Function: This is a remote position. We are in search of a Senior Credentialing Specialist who will be responsible for all aspects of credentialing, re-credentialing, and privileging processes for health/medical providers hired...Remote work
$35k - $48k
...Education Required: BA/BS US Citizenship: Required Summary The MIL Corporation seeks a Junior Compliance Officer (Operations, Jr. Analyst) to support a federal law enforcement client with I9 audit support services and worksite enforcement compliance activities...Full timeContract workFor contractorsWork at officeRemote workWeekend work$85.56 - $152.95 per hour
...With A Strong Financial Advocacy along with State and Federal Regulatory Compliance Background.... Do you excel in navigating complex... ...procedures. Responsible for resolving escalated issues, including CMS, other regulatory bodies, legal, clinical, or patient experience...CmsMinimum wageFull timeWork at officeRemote workShift work$15.58 - $21.19 per hour
...knowledge of authorization requirements and payer guidelines. Maintain a knowledge of Medicare (CMS) guidelines as it relates to admissions and outpatient services. Ensuring compliance with admissions forms, benefit entitlement verification, and billing requirements....CmsPart timeWork at officeImmediate startShift workWeekend work- ...Job Description Job Description Primary Job Responsibilities ~ Support compliance with all regulatory agencies as well as MCO. Client file audit Foster Parent File Audit Incident report tracking track Occurrence Reports Responsible for facilitating and...
$28.08 per hour
...your base hourly rate, you may be eligible to receive an additional health and welfare payment for each hour you work to ensure compliance with the minimums set forth by the act. The amount you are entitled to receive will vary depending upon the fringe benefits you select...CmsHourly payContract workFor contractorsWork at officeLocal area- ...contingent upon award of contract SOSi is seeking a Risk and Compliance Analyst to support mission requirements for a structured approach to... ...regulations. The contractor shall submit a quarterly Regulatory Compliance & Risk Assessment Report, identifying risks, compliance...Full timeContract workFor contractorsRemote workWorldwide
- A healthcare organization in Albuquerque is seeking a Compliance Specialist to support regulatory compliance efforts. This full-time role involves researching State and Federal laws, assisting with compliance audits, and coordinating with the HIPAA Privacy Officer. Qualified...Full time
$19.28 - $23.93 per hour
A health sciences facility in Albuquerque seeks a CREDENTIALING SPECIALIST to coordinate and manage the credentialing and privileging processes for medical providers. Successful candidates will have a high school diploma or GED and at least 2 years of related experience...Hourly payFull time
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