- 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 Reporting, ... 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)
- …on legal matters involving managed care and payer contracting, value-based reimbursement models, and contract negotiation strategies. The successful candidate will ... issues relating to payor relationships, third-party administrators, Medicare Advantage, and Medicaid Managed Care. This position requires at least 8 years of… more
- Houston Methodist (Houston, TX)
- …stay are medically necessary, communicating clinical information to payors to ensure reimbursement . In addition to performing the duties of a CM, this position ... of timely disposition options to assure maximum benefits for patients and reimbursement for the hospital. + Secures reimbursement for hospital services… more
- Omaha Children's Hospital (Omaha, NE)
- …procedures, and productivity to ensure timely resolution of third-party reimbursement , department issues. Responsible for analyzing, recommending updates and changes ... + Stays abreast of changes in the industry by keeping current with CMS, Medicaid , HIPAA and payor billing regulations as well as market changes through workshops,… more
- TEKsystems (Morrisville, NC)
- …offered by all payer types including private/commercial and government (ie, Medicare, Medicaid , VA and DOD); with expertise in Medicare Part B Navigates through ... as needed. Skills Prior authorization, Pharmacy, Medicare, Insurance verification, reimbursement , Care coordination, insurance billing, Health care, Data entry,… more
- MaineGeneral Health (Augusta, ME)
- …records and coding procedures to ensure the facility receives proper reimbursement . Prepares and electronically transmits reports to the national Medicare and ... Medicaid database. + Monitors and evaluates resident care to...development and advancement opportunities + Student Loan Assistance: Potential reimbursement to help you thrive Scheduled Weekly Hours: 40… more
- Houston Methodist (Nassau Bay, TX)
- …are medically necessary, communicating clinical information to payors to ensure reimbursement . **PEOPLE ESSENTIAL FUNCTIONS** + Communicates in an active, positive ... of timely disposition options to assure maximum benefits for patients and reimbursement for the hospital. + Applies approved utilization criteria to monitor… more
- Henry Ford Health System (Troy, MI)
- …teams, ensuring optimal and compliant Mid-Revenue Cycle processes within value-based reimbursement models and initiatives. Reporting to the Director, Risk Adjustment ... to effectively manage the transition from Fee for Service toward Value-Based Reimbursement at Henry Ford Health System. EDUCATION AND EXPERIENCE: + A Bachelors… more
- Mercy Haven Inc. (Islip Terrace, NY)
- …every other Thursday | Full Time | Medical, Dental, Vision, Health Reimbursement Account, PTO, Basic Life, Supplemental, STD, LTD, Tuition Reimbursement , ... long-range service plans + Assists in securing and maintaining entitlements: SSI/SSD, PA Medicaid , SNAP, Section 8 housing, etc. + Conducts weekly home visits and… more
- National Health Care Associates (Wethersfield, CT)
- …personalized resident care plans and ensures the capture of clinical reimbursement for services provided. **Key Responsibilities:** + Determine Patient Driven ... by assessing their nursing needs and determining appropriate clinical reimbursement levels + Complete and assure the accuracy of...the MDS, Electronic Medical Record (EMR), PDP, MDS 3.0, Medicaid and Medicare requirements helpful + Interest in the… more