- WellSpan Health (Ephrata, PA)
- …instructions to patients and other customers of the laboratory. + May review physician orders for supporting documentation. + Resolves billing problems and/or ... health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and… more
- WellSpan Health (York, PA)
- …and patient has been notified. Provides related education, counseling, ongoing review , and monitoring regarding diagnostic tests (ie, INR results in Anticoagulation ... health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and… more
- Penn Medicine (Bala Cynwyd, PA)
- …Education sessions complete with prepared materials. Responsibilities: + Performs systematic review of outpatient and inpatient records to ensure that documentation ... abreast with all the changes in the CPT coding, CMS regulations, local Medicare carrier (Novitas) in order to provide the most accurate information when… more
- Prime Therapeutics (Harrisburg, PA)
- …or equivalent training and/or experience + Experience within the PBM industry, Medicaid, Medicare , and health plans + Pharmacist / Pharm D + Experience with contract ... ranges from $164,000.00 - $279,000.00 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page… more
- WellSpan Health (Mount Gretna, PA)
- …of care assessments as needed to facilitate referrals to treatment. + Helps to review and manage the Recovery Support Department work queue. + Maintains the WARM ... health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and… more
- WellSpan Health (Mount Gretna, PA)
- …through interdisciplinary collaboration, Shared Decision Making activities including peer review . Integrate Shared Decision Making by unit committee membership or ... health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and… more
- Healthfirst (PA)
- …the care plan for assigned members and conducts pre-certification, concurrent review , discharge planning, and case management as assigned. The Case Manager, ... Certified Case Manager + Interqual and/or Milliman knowledge + Knowledge of Centers for Medicare & Medicaid Services (CMS) or New York State + Department of Health… more
- UPMC (Pittsburgh, PA)
- …medication information and accurately enter it into the electronic chart for review by a pharmacist. Coordinate with health care professionals to facilitate any ... and resolve rejected claims, reliably coordinate multiple benefit payers, including Medicare obtaining all necessary paperwork including assignment of benefit forms.… more
- Aveanna Healthcare (Bala Cynwyd, PA)
- …are processed according to guidelines + Prepare and maintain payroll files + Review and audit weekly net profit reports and communicate discrepancies to management ... change at any time with or without notice. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all… more
- Penn Medicine (Philadelphia, PA)
- …regulatory requirements impacting lab operations including AABB, CMS (Center for Medicare /Medicaid Services), DOH (Appropriate state Dept. of Health), DOH (Bureau of ... in a manner which complies with all regulatory requirements; Ensures that review of department operating policies and processes are performed within required time… more