- Aveanna Healthcare (Milford, DE)
- …+ 1-year RN experience in a health care setting As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements ... Health, Dental and Vision Benefits + Tuition Discounts and Reimbursement + PTO, Sick Time, and Paid Holidays Requirements:...the state of application + Valid CPR Preferred: + Medicare Skilled Nursing experience + Basic understanding of Oasis… more
- Kelsey-Seybold Clinic (Cypress, TX)
- …has achieved an overall rating of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive years, including ... patients to specialists and other healthcare providers. + Understands reimbursement criteria and Endocrinology billing/coding. + Performs specific duties delineated… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …national Medicare D plans, third party insurance companies, and all state Medicaid plans to ensure maximum payer reimbursement adhering to critical deadlines ... and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and their… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- … Medicare D plans, third party insurance companies, and all state Medicaid plans to ensure maximum payer reimbursement adhering to critical deadlines* ... and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and their… more
- Trinity Health (Livonia, MI)
- …code(s) by utilizing coding guidelines established by: + The Centers for Medicare / Medicaid Services (CMS) ICD-CM Official Coding Guidelines for Coding and ... codes, modifiers, internal edits and claim edits that could impact hospital reimbursement . Interprets bundling and unbundling guidelines (NCCI edits) as well as… more
- RWJBarnabas Health (West Orange, NJ)
- …contractual and regulatory issues relating to payor relationships, third-party administrators, Medicare Advantage, and Medicaid Managed Care. This position ... on legal matters involving managed care and payer contracting, value-based reimbursement models, and contract negotiation strategies. The successful candidate will… more
- BrightSpring Health Services (Louisville, KY)
- …national Medicare D plans, third party insurance companies and all state Medicaid plans to ensure maximum payer reimbursement adhering to critical deadlines ... Dental, Vision, and Life Insurance + Company-Paid Disability Insurance + Tuition Assistance & Reimbursement + Employee Discount Program + 401k Plan + Paid Time Off +… more
- Molina Healthcare (Warren, MI)
- …in Business, Health Administration, or related field. **Preferred Experience** Experience with Medicaid and Medicare managed care plans. To all current Molina ... the Plan's membership. + Develops and maintains a market-specific provider reimbursement strategy consistent with Reimbursement Tolerance Parameters (across… more
- Molina Healthcare (Layton, UT)
- …familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not ... marketable providers. Contract/Re-contracting with large scale entities involving custom reimbursement . Executes standardized Alternative Payment Method contracts. Issue escalations,… more
- National Health Care Associates (Bath, ME)
- …federal regulations governing the MDS, Electronic Medical Record (EMR), PDP, MDS 3.0, Medicaid and Medicare requirements helpful + Interest in the nursing needs ... personalized resident care plans and ensures the capture of clinical reimbursement for services provided. **Key Responsibilities:** + Determine Patient Driven… more