Medicare Compliance Advisor - Claims & Payment Integrity
Centene Corporation
Centene Corporation is seeking a Medicare Compliance Advisory expert to support day-to-day execution of the Medicare Compliance Program in alignment with CMS requirements and state regulations. You will provide regulatory guidance, conduct research, track issues, and support audit readiness while collaborating with leadership to interpret requirements and document risks. This role offers flexible work arrangements including remote, hybrid, field or office schedules, and a comprehensive benefits #J-18808-Ljbffr Centene Corporation
- Elevance Health is seeking a Carelon Payment Integrity Manager - Kansas to oversee accuracy of claims payments, prevent errors, and ensure compliance with applicable rules. The role collaborates with health plan leaders to monitor fraud, waste, and abuse programs and to...Claims
- Elevance Health is seeking a Carelon Payment Integrity Manager in Kansas to oversee claims payment accuracy and fraud, waste, and abuse prevention. The role... ...plan leaders and cross-functional teams to enforce compliance with state and federal rules. The position requires...ClaimsWork at office
- ...leadership to the provider payment integrity and reimbursement policy functions... ..., to promote accuracy in claims payment and correct coding... ...activities. Ensures alignment and compliance with industry standards and... .... Serve as a trusted advisor to executive leadership on payment...Claims
- Job Title Carelon Payment Integrity Manager - Kansas Location Kansas Hybrid Work Model Associates... ...for ensuring the accuracy of claims payment through the prevention, detection... ...enforcement of fraud, waste, and abuse compliance programs to prevent and detect potential...ClaimsWork experience placementWork at officeLocal areaDay shift2 days per week1 day per week
- ...Carelon Payment Integrity Manager - Kansas Location: Kansas Hybrid: This role requires... ...responsible for ensuring the accuracy of claims payment through the management of a robust... ...of the fraud, waste, and abuse compliance program to prevent and detect potential...ClaimsFull timeTemporary workWork experience placementWork at officeLocal area2 days per week1 day per week
$87.7k - $157.8k
...responsible for supporting the day-to-day execution of the Medicare Compliance Advisory program in alignment with CMS requirements and applicable... ...completion of deliverables. Serve as a compliance advisor and subject matter resource for Medicare programs by interpreting...ClaimsFull timePart timeWork at officeRemote workFlexible hours- The Compliance Specialist is a key member of the Helpside team, working... ...protect the performance and integrity of Helpside’s PEO operations.... ...rate verification, invoice payments, and accurate client billing... ...assist with the unemployment claims process Coordinate with the...ClaimsContract workWork at office
- The Senior Technical Compliance Analyst is an integral team member of the QTS Security Risk & Compliance Team and reports to the Manager, Information... ...in the investigation of any complaint or discrimination claim.The "Know Your Rights" Poster is included here:Know Your...ClaimsFull time
$20 - $24 per hour
...You will be responsible for accurately and efficiently posting payments, adjustments, and denials to patient accounts. A strong understanding... ...manner. Ensure all transactions are balanced daily. ERA and Claim Management: Proactively identify and resolve ERA gaps (...ClaimsHourly payRemote workFlexible hours- Travelers in Overland Park, KS is seeking a Claim Associate under moderate supervision. You will partner with claim professionals to... ...information. Responsibilities include documenting claims, processing payments, and supporting data reporting while maintaining accuracy. The...Claims
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£42.25k per year
...to obtain and provide information when claims are made on a policy. Interview prospective... .... Calculate premiums and establish payment method. Attend meetings, seminars, and programs... ...helping or providing service to others. Integrity Job requires being honest and ethical....ClaimsPart timeWork at officeWeekend work$53.5k - $69k
Safety National is seeking an EDI Operations Specialist to ensure the accuracy and integrity of EDI data. The role requires skills in validating claims data, problem-solving, and collaboration with both internal and external stakeholders. Candidates should have a Bachelor...Claims$26 - $28 per hour
...a critical role in ensuring claims are resolved efficiently and... ...operations teams Ensures compliance with payer, legal, and regulatory... ...to ensure correct and timely payment Monitor and manage... ...and values by demonstrating integrity, dedication, compassion, and...ClaimsWork at office$17 - $34.15 per hour
The Hispanic Alliance for Career Enhancement in Missouri is seeking a Medicare Part B Operations Coordinator to support end-to-end claims processing. This role involves ensuring compliance with CMS requirements and facilitating accurate claim submission through prescriber...ClaimsHourly payFull time$116.2k - $229.1k
...to build, deploy, and operate integrated/verticalized sector solutions... ...serve as trusted advisors to our clients, combining strategic... ...PolicyCenter, Billing, and/or Claims systems) • 4 yrs of experience... ...Underwriting, Claims, Billing & Payments, Policy Administration or...ClaimsVisa sponsorship$91.1k - $143.6k
...collaborative environment? As an experienced Integration Engineer you will have the ability to... ....Ensure alignment with privacy/security/compliance expectations (HIPAA-aware handling,... ...interoperability features).Knowledge of X12 (claims/EDI) for revenue cycle integrations and/...Claims- ...leading provider of clinically integrated eye care. Our national... ...limited to: Billing, Coding, Payment Posting, Accounts Receivable (A/R) follow up, insurance claim submission and managing customer... ...insurance payments for accuracy/compliance based on contracts to ensure...ClaimsWork at officeRemote workHome officeFlexible hoursAfternoon shiftEarly shift
- ...anchored , providing project management, integration, and controls leadership across a... ...PMC Project Manager serves as a trusted advisor to the client, ensuring alignment, integration... ...Support change management, claims avoidance, and commercial alignment Identify...ClaimsFor contractorsHome office
- ...construction, or detailed engineering, but is accountable for integration, controls, and execution assurance on behalf of the Owner.... ...center, and interconnection scopes Support change management, claims avoidance, and commercial risk alignment Program Controls &...ClaimsFull timeFor contractorsWork at officeRelocationHome office
$55.1k - $99k
A leading health organization in Missouri is seeking a Compliance Analyst to ensure adherence to regulatory standards related to program integrity. This position requires a Bachelor's degree and at least 2 years of experience in regulatory, compliance, or legal roles, ideally...Remote job$55.1k - $99k
...job have the flexibility to work remote from home anywhere in the Continental United States. Position Purpose Maintain compliance with program integrity related regulatory laws and standards, while also supporting Program Integrity in maintaining compliance with all...Contract workWork at officeRemote workWork from homeFlexible hours$126.24k - $214.6k
...Veatch CorporationReq Id : 115570Job Title : Integrated Campus Project ManagerLocation : KCP,... ...PMC Project Manager serves as a trusted advisor to the client, ensuring alignment,... ...Risk Management Support change management, claims avoidance, and commercial alignment Identify...ClaimsPart timeFor contractorsWork experience placementWork at officeLocal areaHome officeVisa sponsorshipFlexible hours$52k - $78k
Are you a detail-driven compliance professional who thrives in a fast-paced, ever-evolving... ...appropriate filing action Maintain accuracy and integrity of Swiss Re's internal tracking system... ...exposure, whilst our industry-leading claims service provides them with additional...ClaimsFull timeTemporary workWork experience placementWork at officeRemote workWorldwideVisa sponsorshipRelocation packageFlexible hours- Integrated Campus Field Project Manager Locations: Overland Park, KS; Dallas, TX; Greenwood Village, CO; Canonsburg, PA; Austin, TX; San... ...center, and interconnection scopes. Support change management, claims avoidance, and commercial risk alignment. Maintain integrated...ClaimsFull timeFor contractorsWork at officeRelocationHome office
$72.5k - $108.8k
...determination, and management of long-term disability claims. The Senior Case Manager I, LTD acts... ...investigations if applicable Calculates benefit payments, which may include partial disability benefits, integration with other income sources, survivor benefits, residual...ClaimsContract workWork experience placementWork at officeFlexible hours2 days per week- ...The Opportunity The Integrated BESS Execution Director (Director) provides executive leadership... ...schedule, quality, safety, contractual compliance, client satisfaction, and financial... ...effective management of change orders, claims, warranty matters, and commercial risks....ClaimsContract workFor subcontractorWork at officeRemote work2 days per week3 days per week
$46.99k - $122.4k
...at a time. Position Summary The Program Integrity Auditor is responsible for the review of... ..., recoupment of funds or rebilling of claims, and referral to state regulators for any... ...coding and documentation rules. Maintain compliance with company policies and procedures....ClaimsHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hours- ...Managers and internal departments under the AVP, Resolution Management Operations Leader. Key tasks include preparing UPP reports, Care and Preservation, and wrap-up reports; maintaining SBA communication; tracking denied claims and #J-18808-Ljbffr Enterprise Bank & TrustClaims
- ...a collaborative environment that values integrity and growth, explore our exciting workers... ...everywhere! We are seeking a skilled Senior Claims Representative to enhance our team.... ...or compensation agreements, and process claim payments efficiently. #J-18808-Ljbffr ChubbClaims
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