preparation of compliance testcases reviewing compliance controls using samples from previous audit findings, CMS program audit..., HIPPA guidelines, CMS reports etc. Ensure the business scenarios are executed on the system to support high quality...
requests for medical necessity and refer to medical director any referral that requires additional expertise. Utilize CMS... of referrals. Knowledge of CMS chapter 13 Maintain goals for established turn-around time (TAT) for referral processing...
and time parameters. Controls and monitors costs, analyzes and reconciles budget variances and takes appropriate action..., CEBS, CMS) is preferred....
for organizational compliance with CMS and State transmittals, HPMS notices, CMS and State required applications and submissions..., implementation, and maintenance of audit controls and measurements for internal and external processes, ensuring correct processes...
that the site care management programs for the assigned region operate under compliant CMS, federal and state practice.... Develops and recommends operating and capital budgets and controls expenditures within approved budget objectives. Responsible...
professionals Knowledge of CMS guidelines, regulations, NCQA® and HEDIS® Familiar with Special Needs Plan (SNP) programs Active... regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands...
based on CCI edit report to comply with CMS guidelines Serves as a resource to Management, Customer Service, Utilization... regulations and guidelines including: CMS DMHC DHCS guidelines Proficiency with Excel Knowledge of Correct Coding...
, engineering, project controls, procurement, construction management, and CQV of technically complex facilities, primarily in the.... Lead the established site safety program in your area and monitor performance with CMs and Superintendents on site...
and Supplemental Rebates. Analyst is accountable for submitting payments within deadlines and in compliance with CMS guidelines... recommendation on state disputes, apply proper amounts to be paid & ensure CMS codes are applied correctly; notify states of results...
based on CCI edit report to comply with CMS guidelines Serves as a resource to Management, Customer Service, Utilization... regulations and guidelines including: CMS DMHC DHCS guidelines Proficiency with Excel Knowledge of Correct Coding...