- St. Luke's University Health Network (Quakertown, PA)
- …applicable state/federal regulatory notices as applicable ie.) Important Message from Medicare (IMM), Medicare Outpatient Observation Notice (MOON), Bundle ... Payment Care Initiative (BPCI) notification. + Monitors risk assessment using available tools and implements discharge interventions accordingly. + Actively addresses and monitors resource utilization and documents delays as appropriate. + Identifies patients… more
- CenterWell (Harrisburg, PA)
- …quality and cost improvement for high-risk senior populations in full risk Medicare arrangements. This individual will help assess the value of each opportunity ... quality and value drivers in full risk care delivery, ideally in Medicare /seniors + Demonstrated ability to work collaboratively with clinical and operational… more
- Aveanna Healthcare (Chester, PA)
- …with or without notice. Vaccination Requirements As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements ... leaves of absence, compensation, and training. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements… more
- University of Pennsylvania (Philadelphia, PA)
- …and financial implications. + Understanding and keeping current with FDA and Medicare regulations applicable to clinical trials. + Understanding interaction of ... Medicare regulations and/or third-party insurance to develop clinical trial budgets. + Preparing financial analyses, as necessary, and serving as a resource to… more
- Guthrie (Sayre, PA)
- …five (5) years. Knowledge and ability to demonstrate understanding of Medicare /Medicaid regulations, Medicare Advantage UM rules/regulations, and Commercial ... payer rules/regulations regarding medical necessity, patient types, etc. Must be able to provide evidence of knowledge in and experience of payer contract language, as it relates to utilization management. Can navigate through the requirements imposed by all… more
- WellSpan Health (York, PA)
- …Care* Follows Conditions Of Participation to ensure all regulations are followed under Medicare .* Ensures that quality and efficient care is provided to all patients ... consultation/advisement as needed. **Common Expectations:** + Understands and follows Medicare Conditions of Participation, established policies and procedures and… more
- Trinity Health (Newtown, PA)
- …medical necessity and issues Advanced Beneficiary Notice as appropriate for Medicare primary outpatients. Provides cost estimates. Collects and documents Medicare ... Questionnaire and obtains information from the patient if third party payers need to be billed (ie worker's compensation, motor vehicle accidents and any other applicable payer). + Financial Advocacy: Screens all patients self-pay & out of network patients… more
- St. Luke's University Health Network (Easton, PA)
- …issuing applicable state/federal regulatory notices (for example: Important Message from Medicare (IMM), Medicare Outpatient Observation Notice (MOON), Bundle ... Payment Care Initiative (BPCI) notification) as applicable. + Demonstrates team work and flexibility regarding assignments. PHYSICAL AND SENSORY REQUIREMENTS: Sitting for one to two hours at a time, walk on all surfaces for up to five hours a day, and climb… more
- Sedgwick (Harrisburg, PA)
- …limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. + Reports claims to the excess carrier; responds to requests ... principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business. + Excellent oral… more
- Datavant (Harrisburg, PA)
- …work environment. + Keep up to date with current coding policies for ICD-10, Medicare Advantage, HHS (ACA), and other markets. + Provide guidance and make strategic ... or inpatient setting. + Current CCS, CRC, or CPC required. + Previous Medicare Advantage Risk Adjustment, CDI, Medicaid, Commercial RA, and HEDIS experience. +… more