Medicare Regulatory & Coding Expert — UM/ACD Specialist
Acentra Health
Acentra Health is seeking a Medicare Regulatory and Coding Expert Associate to join our team in a regulatory coding capacity. You will manage an internal ACD database, monitor CMS transmittals, and collaborate with clients and claims administrators to ensure compliance and accuracy. The role requires applying medical necessity criteria, maintaining QA standards, and ensuring HIPAA compliance while supporting utilization management initiatives and producing timely, accurate guidance for clinical #J-18808-Ljbffr Acentra Health
$29.25 - $36.56 per hour
...Responsibilities Acentra Health is looking for a Medicare Regulatory and Coding Expert Associate to join our growing team.... ...to as the Action Code Database (ACD). Maintaining the database requires... ...1+ year of Utilization Management (UM) and/or Prior Authorization or...RegulatoryContract workWork at officeLocal areaFlexible hours$27.02 per hour
...government programs such as Medicare Advantage (MA) and Affordable... ...Hierarchical Condition Category (HCC) Coding, medical coding, clinical... .... Assists with Regulatory Audits by performing first coding... ...Coder (CRC) Certified Coding Specialist (CCS) Registered Health Information...RegulatoryFor contractorsWork at officeLocal areaRemote workFlexible hours$91k - $202.8k
...success. As a Portfolio Analytics & Strategy Specialist within PNC's Consumer Data Solutions &... ...business performance, risk management, regulatory compliance, and customer data strategy.... ....• Strong Python programming and coding experience including: Data Analysis, Data...RegulatoryFull timeTemporary workPart timeWork experience placementWork at office- ...SAFETY & PHARMACOVIGILENCE SPECIALIST (2 positions) Job Title: Safety and PV Specialist x... ...for the reporting of adverse events to regulatory agencies Develops and ensures the uniform... ...of safety databases and/or MedDRA coding preferred. ~ Experience leading clinical...RegulatoryPermanent employmentContract workSecond jobWork at officeRemote work
- ...maintaining the accuracy, integrity, and regulatory compliance of the organization's Charge... ...Finance, Clinical Operations, Compliance, Coding, and Information Technology teams to... ...implications.Serves as a billing and coding expert for the department by: providing...Regulatory
- ...Solutions is seeking an experienced Senior Coding Specialist to support our end - to - end appeals... ...operationalize coding guidelines, regulatory requirements, and client policies; identify... ...denials. Interpret and apply Medicare, Medicaid, and commercial payer rules...Regulatory
- Adventist HealthCare seeks a Clinical Documentation Specialist to ensure documentation accuracy, support proper ICD-10-CM/PCS and CPT coding, and collaborate with physicians and the coding team. The role emphasizes regulatory alignment with CMS guidelines and ongoing...RegulatoryRemote job
- Job Title S & P Specialist Location Bethesda, MD 20817 US (Primary) Category Drug Safety Job... ...for the reporting of adverse events to regulatory agencies Develops and ensures the... ...Knowledge of safety databases and/or MedDRA coding preferred Experience leading clinical and...RegulatoryFull timeWork at officeLocal areaRemote work
- ...job in the Medical field? Virginia Cancer Specialists, an affiliate of McKesson Specialty... ...Oncology Compliance Program, to include the Code of Ethics and Business Standards.... ...requirements for all payers, State and federal regulatory guidelines for coverage and...RegulatoryFull timeWork at office
- ...payer reimbursement policies and procedures, regulatory and administrative rules. Coordination of patient access experience. Expert knowledge of specialty products,... ...healthcare/ insurance experience. Billing/Coding background in buy and bill and Specialty Pharmacy...RegulatoryShift work
$133.3k - $180.3k
...compliance policies across a complex and rapidly evolving global regulatory landscape. In this role, you will serve as Amazon's senior... ...worldwide.You will manage and develop a team of junior subject matter experts, fostering their growth into well-rounded compliance...RegulatoryWorldwideFlexible hours- ...DescriptionProSidian Consulting seeks a FOIA Subject Matter Expert to support and participate in a project... ...Seven (7) years’ experience in law and regulatory compliance• Understanding and familiarity... .... Be sure to place the job reference code in the subject line of your email. Be...RegulatoryFull timeFor contractorsInternshipWork at office
- ...tremendous scale. We enable Health Plans to meet regulatory requirements, improve care coordination... ...resides in our broader “Subject Matter Expert” team. This team was formed as a result... ...understanding of:Medicaid & Medicare program structuresCMS oversight and compliance...RegulatoryPermanent employmentWork experience placementWorldwide
- ...an Operations Management Subject Matter Expert to support and participate in a project supporting... ...impact of existing and proposed regulatory considerations, approvals required by main... ...CONSIDERED. Be sure to place the job reference code in the subject line of your email. Be...RegulatoryFull timeFor contractorsInternshipWork at office
- ...Environmental Health (SOEH) Senior Analyst and Subject Matter Expert (SME)Concurrent Technologies CorporationArlington, VA Minimum Clearance... ...training requirements.Supports engagements with Federal regulatory agencies (e.g., OSHA, EPA, FDA), interagency partners, and technical...RegulatoryFull timeFor contractorsWork at office
$20k
BSA/AML Specialist x 2 -Contract - Remote- $28.00 - $32.0/hr.Apply promptly! A high volume of applicants is expected for the role as detailed... ...submit Currency Transaction Reports (CTRs) within required regulatory timeframes.• Review daily internal referrals, including...RegulatoryHourly payContract workLocal areaRemote workWork from homeVisa sponsorship- VHC Health is seeking a Registered Cardiovascular Invasive Specialist (RCIS) to support the Cardiac Catheterization and Electrophysiology Lab. The role involves assisting physicians across diagnostic catheters, PCI, device implantations, ablations, and EP studies, with...
- ...contact with customers, subcontractors, and internal stakeholders throughout the lifecycle, ensuring compliance with FAR/DFARS and regulatory requirements. You will lead contract negotiations, analyze complex bid tenders, and collaborate with senior management. #J-18808...RegulatoryContract workFor subcontractor
- ...safety industry leader. We are expert FERC Part 12 Dam Safety... ...Hydropower Practice engineering and regulatory team offers core services... ...environmental scientists and regulatory specialists. Hydropower generation is... ...have limited or no specific code based guidance.Work with...RegulatoryContract workWork at officeFlexible hours
- ...timeDescriptionClient Solution Architects (CSA) is currently seeking an Specialist II to support onsite in the Arlington, VA area.For nearly 50... ....Ensure all deliverables comply with applicable statutory, regulatory, and command-specific requirements and contribute to audit...RegulatoryContract workFor contractorsWork at office
$122.1k - $164.8k
...based on this focus. This leader acts as a privacy subject matter expert and works with business, legal, and technology stakeholders to... ...improve the documentation team program• Apply global privacy regulatory and operational expertise to Ops to embed a consistent customer...RegulatoryFlexible hours- ...Who YOU AreYou’re a dedicated Fire Safety Specialist with a strong commitment to ensuring the... .... With your extensive knowledge of fire codes, standards, and best practices, you play... ...function optimally and comply with regulatory requirements.At KBR, you bring a detail-...RegulatoryFull timeContract workLocal areaShift workNight shift
- ...inquiries and provide transaction status updates.Maintain accurate records and documentation in accordance with internal policies and regulatory requirements.Support continuous improvement efforts to enhance payment operations and reduce risk.Required...RegulatoryShift work
- ...workforce. The Scheduler and Authorization Specialist is responsible for performing a variety... ...identify diagnosis (CPT and ICD-10 coding). # Operate online insurance verification... ...Ensures consistent compliance with all regulatory and CAO guidelines, policies, and...RegulatoryWork at office
- ...Opportunity:Tetra Tech is adding a Title 22 Specialist to our Tetra Tech team based in... ...complex challenges. Our industry-leading experts in engineering and consulting are committed... ...processes, and ability to interpret statutory/regulatory requirements into practical program...RegulatoryContract workFor contractorsWork at officeWorldwide
- ...Mobility - you may be required to relocate during or after completion of your training. Successful completion of all training and regulatory requirements as identified in the applicable training plan Must meet suitability for Federal employment If authorized, PCS...RegulatoryPermanent employmentFull timePart timeWork experience placementWork at officeRelocationTrial period
- ...and local regulations and/or guidelines, the Tissue Recovery Specialist 1 will perform a variety of duties associated with the surgical... ...Employees must arrive onsite at the start of the shift. Mandatory and regulatory competencies, as well as meeting attendance along with...RegulatoryWork at officeLocal areaShift workNight shiftWeekend workDay shift
- ...Legal Specialist We are looking for candidates with 1-5 years of experience ideally with knowledge of legal regulations, court orders... ..., and member information to ensure accurate processing and regulatory compliance. Monitor queues and workloads to ensure timely processing...RegulatoryLocal area
- ...management activities for both waterfall and agile methodologiesSupport the design and implementation of solutions that comply with regulatory standards in GxP and non-GxP environmentsSupport the accurate and timely design, creation, and migration of scientific master...RegulatoryLive inWork at officeLocal area
$120k - $190k
Title: Product Support Subject Matter Expert LCAT: Operations Research Analyst SME Level 3 Location: Arlington, VA Work Arrangement:... ...handling Maintain documentation in accordance with contractual and regulatory standards Required Qualifications Preferred Qualifications/...RegulatoryTemporary workFor contractorsFor subcontractorLocal areaRemote work
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