- Signature Healthcare (Lexington, KY)
- …Assessment Instrument (RAI), Prospective Payment Systems (PPS), Quality Measures (QM's), Medicaid Casemix and Medicare guidelines for all SHC stakeholders. + Assist ... and collaborate with Clinical Reimbursement Specialist with onboarding of new MDSC. + Exhibit competency...the RAI, Care Planning, PPS, Medicare, and when applicable Medicaid Case Mix What you Need to make a… more
- Stanford Health Care (Palo Alto, CA)
- …and state regulations and guidelines, CMS (Centers for Medicare and Medicaid Services) and OIG (Office of Inspector General) compliance standards. **Locations** ... be removed from an account + Conducts audits for Medicare/ Medicaid Cost Outlier accounts prior to billing, ensuring itemized...Licensure required . or + CCS - Certified Coding Specialist required . or + CPC and/or CCSP -… more
- Penn Medicine (Lancaster, PA)
- …are placed in compartments for specified days of the week + Provides specialist health check services, such as measuring and fitting compression hosiery, monitoring ... A health care provider in good standing with Medicare, Medicaid , and other federal and state health insurance programs,...insurance programs, ie not excluded from participation in Medicare, Medicaid or any other federal or state health insurance… more
- Humana (Richmond, VA)
- …to meet their needs. + Collaborates with Community Health Workers (CHW), Housing Specialist and other internal and external agencies for HRSN needs. + Primary point ... a full-time schedule. **Preferred Qualifications** + Prior experience with Medicare, Medicaid and dual eligible populations. + Bachelor's Degree Nursing (BSN). +… more
- UnityPoint Health (Cedar Rapids, IA)
- …and department compliance for federally funded healthcare programs (eg Medicare and Medicaid ) regarding fraud, waste and abuse. Brings any questions or concerns ... and department compliance for federally funded healthcare programs (eg Medicare and Medicaid ) regarding fraud, waste and abuse. Brings any questions or concerns… more
- Care Plus NJ (Paramus, NJ)
- …requirements and criteria of each plan. Job Summary: As an Accounts Receivable Specialist in our Finance Department, you will be responsible for meeting monthly ... and reimbursement. The role requires strong knowledge of NJ Medicaid and Medicare billing, collaboration with clinical and executive...2-3 yrs. experience working with all Medicare and all Medicaid plans; knowledge of NJMMIS and CMS required +… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- …meetings when requested by the Program Manager. As the discharge planning specialist , you will be responsible for accurately completing all forms and documents ... possess extensive knowledge of community resources for older persons, Medicare, Medicaid , and insurance requirements as they relate to continuing care. Familiarity… more
- CVS Health (Madison, WI)
- …and predetermination of covered benefits in the commercial, Medicare, and Medicaid environment. This Wheelchair DME consultant provides subject matter expertise in ... application of Aetna policies and practices for commercial, Medicare, and Medicaid environments. ◾Proactively use data analysis to identify opportunities for quality… more
- Signature Healthcare (Cookeville, TN)
- …choice in the healthcare industry. Overview The ideal Clinical Reimbursement Specialist Candidate is very detailed orientated, organized, self-motivated, a love for ... Assessment Instrument (RAI), Prospective Payment Systems (PPS), Quality Measures (QM's), Medicaid Casemix and Medicare/ Medicaid guidelines for all SHC… more
- Hartford HealthCare (Farmington, CT)
- …a multi-entity hospital and professional office environment, the Financial Counseling Specialist is responsible for analysis, investigation and resolution of patient ... and transfers. 3. Performs pre bad debt screening (reviews accounts for Medicaid Eligibility and/or bad debt vs. charity care). 4. Updates insurance information… more