University Of Miami Work Values

Daily Duties at University Of Miami:

Develop presentations, and disseminated information in oral and written form with all level of management and regulatory agencies. Manage operational compliance including bid filing and other required CMS reporting/filings related to Medicare Advantage products and operations. Provide guidance regarding adherence to all product, network, sales and other operational compliance processes and CMS regulatory requirements. Ensured that healthcare professionals as well as healthcare facilities were compliant with rules and regulation required by Medicare/Medicaid, Federal False Claims Act, Stark, HIPAA, Anti-kickback & Fraud and Abuse and other laws imposed by the Food Drug Administration (FDA). Review Managed Care Plans to identify which providers are on the Exclusion list from participating in Federal and State Health Care Programs. Identifying in networking providers and collected reimbursement from out of networking providers who billed and submitted claims performed on eligible members within the Managed Care Plan. Review business arrangement contracts to ensure that the terms and conditions are bona fide. Investigate potential areas of compliance vulnerability and risk; develops and implement corrective action plans for resolution of problematic issues, and provides corrective action plans and general guidance in regards to avoiding or dealing with similar situations in the future.

What they like about University Of Miami:

Working for a company with an emphasis on social values and helping society is a clear and important priority for you - a critical factor in who you choose to work for. In contrast to other factors, you place an organization's reputation for fairness and concern for the community above most other aspects of the company. As you search for a new job opportunity, it is usually possible to find out if the company is involved in the community and/or if it is addressing problems and issues in society. Pay special attention to non-profit organizations and those specifically involved in social action. Moreover, speaking with current and former employees should enlighten you to perceptions of the fairness of the company's leaders and the treatment of employees.

Tags

Fraud, Medicare, Coding, Billing, Health Insurance Portability And Accountability Act, Licensing, Training, Compensation, Medical, Compliance, management, manager

Skills

Fraud, Medicare, Coding, Billing, Health Insurance Portability And Accountability Act, Licensing, Training, Compensation, Medical, Compliance

These are some of the questions we asked our climbers about their experiences with University Of Miami: