- Robert Half Accountemps (Doylestown, PA)
- …part in maintaining the financial health of our organization by handling Medicare billing, patient accounts, and insurance claims with precision and efficiency. ... to manage accounts through to their final resolution. Responsibilities: Process Medicare billing activities, ensuring accurate handling and management of patient… more
- Prime Therapeutics (Harrisburg, PA)
- …qualified entities across all lines of business to support the Centers for Medicare & Medicaid Services (CMS) Star and HEDIS quality measure programs, including but ... meets the specialized needs of the targeted population; for Medicare , is Centers for Medicare & Medicaid...$17.85 - $25.48 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our… more
- Prime Therapeutics (Harrisburg, PA)
- …strategy. This role provides leadership and subject matter expertise on Medicare Stars, Medicaid quality and the Commercial/Health Insurance Marketplace Quality ... goals + Drive the client quality strategy for all lines of business ( Medicare , Medicaid, Commercial/HIM); serve as primary point of contact and subject matter expert… more
- Prime Therapeutics (Harrisburg, PA)
- …lines of business (Employer Markets, Health Insurance Marketplace (HIM), Commercial, Medicare , and Medicaid). This individual is the primary relationship and ... Lead retention efforts for Employer Markets, Health Insurance Marketplace, Commercial, Medicare , and Medicaid health plan clients; drive the adoption and consistent… more
- Intermountain Health (Harrisburg, PA)
- …Integrity (CDI) Registered Nurses (RN) and Intermountain Physician Advisors to review complex facility encounters and assign International Classification of Diseases ... optimization of reviews while patients are hospitalized. It aids in the review of quality measures including Patient Safety Indicators and Hospital Acquired… more
- Redeemer Health Home Care & Hospice (Meadowbrook, PA)
- …ICD-10 and CPT-4 guidelines, UHDDS sequencing guidelines, CMS coding guidelines, Medicare and Medicaid regulations and the American Hospital Association coding ... practitioners. Responsible for consistently meeting quality expectations for documentation review , coding, and meets Redeemer Health's expected productivity standards… more
- Highmark Health (Pittsburgh, PA)
- …drug benefit strategies, drug formularies, and programs specifically for the Medicare Advantage (MA) market. The incumbent will contribute to recommendations for ... and stakeholders across the organization. Key responsibilities will include clinical review , assisting in navigating a complex regulatory environment, working with… more
- UPMC (Williamsburg, PA)
- …Administration (HCFA) the American Osteopathic Association (AOA), and the Residency Review Committee (RRC). Performs day-to-day inpatient and outpatient billing and ... Notifies CCC of payments received at the office via computer reports. + Review payment listings from intermediaries and insurance companies for paid claims and also… more
- CVS Health (Harrisburg, PA)
- … review , diagnosis coding, and/or auditing. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition ... teams prior to the submission to the Centers of Medicare and Medicaid Services (CMS) for the purpose of...Classification of Disease (ICD) codes required. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and… more
- Elevance Health (Harrisburg, PA)
- …member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services ... issues as assigned. + Participates in special projects and review of work done by lower level auditors as...a minimum of 5 years of audit/reimbursement or related Medicare experience; or any combination of education and experience,… more