- Evolent (Topeka, KS)
- …under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid , and is not identified as an "excluded ... medical necessity guidelines, as well as other requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter… more
- Evolent (Phoenix, AZ)
- …under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid , and is not identified as an "excluded ... + **This position is 100% Remote and can be completed from any state . Multiple opportunities for a flexible schedule and both part-time and full-time options… more
- Elara Caring (North Easton, MA)
- …experience in a fast-paced office or healthcare setting preferred + Knowledge of Medicare/ Medicaid , home care benefits, and applicable state policies preferred + ... + Monitor care delivery and assist with implementing quality improvement programs (QAPI) + Foster positive communication and collaboration across the care… more
- Amergis (Fort Worth, TX)
- …cases, and collaborating with multidisciplinary teams to ensure compliance with state and federal guidelines. Assignment Details: + Location: Fort Worth Area, ... case manager for assigned evaluations + Maintain documentation for Medicaid billing and district systems + Participate in ARD...(if applicable) + Current health certificate (per contract or state regulation) + Must meet all federal, state… more
- University of Rochester (Rochester, NY)
- …followed. + Maintains knowledge of all current third-party coverage, federal and state billing, and reimbursement and compliance regulations and procedures. + Serves ... negotiated contracts. + Ensures timely processing of secondary credit balances for government plans. + Reviews reports generated within the billing systems to ensure… more
- Cleveland Clinic (Twinsburg, OH)
- …organizations in the world. Twinsburg Family Health & Surgery Center is a state -of-the-art facility that is dedicated to providing world class care through advanced ... radiation safety measures and protection devices to comply with government regulations and to ensure the safety of patients...Assist with all policies and procedures required by local, state , and federal law, and with compliance or credentialing… more
- UTMB Health (Galveston, TX)
- …Lead the development, negotiation, and management of contracts with commercial and government payers, including HMOs, PPOs, ACOs, and Medicaid /Medicare Advantage ... reimbursement, alignment with organizational goals, and compliance with federal and state regulations. This role will oversee payer relationships, evaluate financial… more
- Humana (Sacramento, CA)
- …contract requires US Citizenship + Successfully receive interim approval for government security clearance (NBIS - National Background Investigation Services) + HGB ... authorized to do work in Puerto Rico per our government contract. We are not able to hire candidates...care service experience or working knowledge of TRICARE ACD program . + Healthcare professional with a Bachelor's degree in… more
- Comunilife (Bronx, NY)
- …looking for an experienced Benefits and Entitlement Specialist for its congregate program in the Bronx, El Borinquen. The El Borinquen Benefit Entitlement Specialist ... entitlements Benefits that may be needed include: Public Assistance, Medicaid , Food Stamps, Social Security Supplement Income/ Disability Insurance, Veteran's… more
- Evolent (Helena, MT)
- …under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid , and is not identified as an "excluded ... necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter… more