- University of Rochester (Rochester, NY)
- …to, authorizations, coordination of benefits, baby not on policy, Cobra entitlement, Medicare Lifetime Reserve days, and Medicare Advantage issues. Communicates, ... of adding newborns onto policy. Determines the primary payer through knowledge of Medicare and other payer regulations for the coordination of benefits. + Notifies… more
- CVS Health (Trenton, NJ)
- …**Position Summary** **Are you passionate about contributing to the well-being of the Medicare population? Would you like to plan an integral and strategic part in ... CVS Health/Aetna is working to transform the way New Jersey Medicare beneficiaries experience health care - improving quality, emphasizing whole-person wellness,… more
- New York State Civil Service (West Seneca, NY)
- …individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or Federally assisted program). ... appointed, you may be required to become an enrolled Medicare provider; obtain and provide to your employer a...to allow for your services to be billed through Medicare and Medicaid. If you are appointed and are… more
- New York State Civil Service (Corinth, NY)
- …individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or Federally assisted program). ... appointed, you may be required to become an enrolled Medicare provider; obtain and provide to your employer a...to allow for your services to be billed through Medicare and Medicaid. If you are appointed and you… more
- New York State Civil Service (New York, NY)
- …individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or Federally assisted program). ... appointed, you may be required to become an enrolled Medicare provider; obtain and provide to your employer a...to allow for your services to be billed through Medicare and Medicaid. If you are appointed and are… more
- Masonicare (Wallingford, CT)
- …and how it relates to facility care practices + Manages the patient's Medicare benefit by communication of skilled needs to the patient, family and interdisciplinary ... care team. + Organize and participate in the daily Medicare meeting, utilization review and monthly end of close...and monthly end of close meetings. + Assists with Medicare denial claims/reviews when need is identified by billing… more
- Atlantic Health System (Morristown, NJ)
- …and data risk classification; (iv) accountable care organization compliance; (v) Medicare C & D/ Medicare Advantage compliance program requirements; (vi) ... compliance program guidance; (iv) CMS Conditions of Participation; (v) Medicare Shared Savings Program Accountable Care Organization Compliance guidance and… more
- Humana (Juneau, AK)
- …insights strategy that supports the improvement of health outcomes within our Medicare population. This role will lead and coordinate survey administration strategy ... build and maintain data insights library and impact to results on the Medicare Health Outcomes Survey. This role will advise executives and senior leadership to… more
- Humana (Salt Lake City, UT)
- …analytics that are meaningful to develop foundational programs for our Medicare population. This role will lead execution of tactics, collaborative development ... or programs and their impact to results on the Medicare Health Outcomes Survey and patient experience. This role...leadership to develop functional strategies that broadly impact the Medicare Stars program. This role will also develop, elevate,… more
- US Tech Solutions (RI)
- …**Responsibilities:** + Ensure accuracy of case setup and clinical review of Medicare appeals cases. + Review internal notes or fax requests thoroughly for ... for clinical information to decision cases + Utilize work instructions and Medicare guidelines for accurate case processing. + Comply with CMS mandated timelines… more