- Evolent (Atlanta, GA)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...part of the application process. This is collected for compliance and security purposes and only reviewed if an… more
- Evolent (Atlanta, GA)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...part of the application process. This is collected for compliance and security purposes and only reviewed if an… more
- Evolent (Atlanta, GA)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...part of the application process. This is collected for compliance and security purposes and only reviewed if an… more
- Humana (Atlanta, GA)
- …following areas: + Insurance Strategy and Solutions + Clinical Operations + Medicare Divisional + Provider Experience + Medicaid **Location:** The summer internship ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Healthfirst (GA)
- …advocate and liaison with various governmental and private agencies such as Medicaid, Medicare , and Social Security to maximize network of support and secure needed ... as needed. + Keeps up to date on federal ( Medicare ) and state (Medicaid) regulations. + Interacts with community...skills **License or Certification:** LMSW or LCSW **Regulatory or Compliance activities:** N/A WE ARE AN EQUAL OPPORTUNITY EMPLOYER.… more
- CenterWell (Atlanta, GA)
- …innovation for chronically and temporarily homebound, polychronic, and high-risk Medicare patients within a full-risk, value-based framework. The Medical Director ... with clinicians, executives, and operational leaders. + Advanced knowledge of Medicare regulations, value-based care principles, and best practices for complex care… more
- COOLSOFT (Decatur, GA)
- …Clinical Data Integrity * Analyze service records for completeness, accuracy, and compliance with billing requirements. * Identify and correct: o Document how data ... E/M codes. o Vaccination Admin Fees not entered for patients with Medicaid, Medicare , or Private Insurance. o Incorrect Service Entry Points ( eg, services entered… more
- Humana (Atlanta, GA)
- …states: California, Hawaii, Nevada, Oregon + Health Plan experience + Previous Medicare /Medicaid Experience a plus + Call center or triage experience + Bilingual ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- CenterWell (Atlanta, GA)
- …residence + Eligibility to participate in federal prescription programs (eg, Medicare /Medicaid) + Self-directed with the ability to work effectively both ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Humana (Atlanta, GA)
- …administrative expenses and quality/bonus performance + Comprehensive knowledge of Medicare policies, processes and procedures **Additional Information** To ensure ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more