- Bon Secours Mercy Health (Cincinnati, OH)
- …opportunities, regulations, standards and directives regarding governmental/third party agencies ( Medicare & Medicaid ) and/or third paLeads assigned negotiations ... opportunities, regulations, standards and directives regarding governmental/third party agencies ( Medicare & Medicaid ) and/or third-party payers. + Adheres… more
- PeaceHealth (Vancouver, WA)
- …improvements. 9. Leads and oversees the regional analysis and reporting for governmental reimbursement programs (eg Medicare , Medicaid , etc.). 10. Leads and ... including but not limited to, compliance with PeaceHealth financial policies and Medicare , Medicaid and other regulatory parameters affecting the financial… more
- WMCHealth (Valhalla, NY)
- …with providers including Blue Cross/Blue Shield, Workers' Compensation, private insurance carriers, Medicare and Medicaid to verify the patient's eligibility for ... payment of their medical treatment and to determine the method of payment/ reimbursement to Westchester Medical Center. This involves coordination with other Medical… more
- Houston Methodist (Houston, TX)
- …customer service focus and application of positive language principles + Knowledge of Medicare , Medicaid , and Managed Care requirements + Knowledge of community ... roles and is responsible for facilitating appropriate length of stay (LOS) and reimbursement for all hospital admissions in accordance with set goals and objectives.… more
- Ellis Medicine (Schenectady, NY)
- …precertification of benefits and coverage; HMO contracts through various agencies, Medicare and Blue Cross eligibility and benefits through the OMNIPRO system, ... Medicaid through the EMEVS system on a daily basis...patient appointments, in advance per the guidelines to maximize reimbursement and allow surgeons ample time to review test… more
- Humana (Springfield, IL)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... and/or other related functions in healthcare/health insurance + Experience with IL Medicaid and FIDE D-SNP + Experience working with key provider types (primary… more
- United Therapeutics (Fort Worth, TX)
- …Teams + Advanced knowledge of medical insurance terminology + Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in ... develop and implement plans that optimize patient access and reimbursement . You are an expert in XX with an... Medicare (Part B and Part D) Job Location This… more
- Centene Corporation (Austin, TX)
- …candidate will have:_** + **_Knowledge of dual contract requirements (eg, Medicare - Medicaid plans)_** + **_Experience managing external audits and communicating ... for its Duals and SMAC regulatory filings. + Manages Duals (and Medicare with D-DSNP specific or separate) compliance reporting responsibilities and respond to… more
- CenterWell (Anderson, SC)
- …Internal Medicine or Geriatric Medicine preferred + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum of two to ... has a strong emphasis on senior-focused primary care for members of Medicare Advantage health plans and is committed to providing personalized, high-quality primary… more
- Gentiva (Fairfax, VA)
- …knowledge of hospice principles, industry standards, regulations, and best practices ( Medicare , Medicaid , JCAHO, ACHC) + Expertise in nursing practice ... for ensuring the appropriate delivery of hospice services, compliance with Medicare Hospice Benefit Conditions of Participation, state regulations, and Gentiva's… more