- Zelis (Plano, TX)
- …claim data, with a focus on various pricing methodologies including Medicare , Medicaid, and commercial reimbursements. This role involves leveraging data to ... analysis, and reporting. + Understand claim payment methodologies such as Medicare , Medicaid, and Commercial Reimbursement. + Create visualizations and dashboards to… more
- HCA Healthcare (Austin, TX)
- …public nursing or acute hospital nursing experience + Familiar with Medicare home health regulations, documentation requirements, ICD-10 coding and PPS (Strongly ... health, public nursing or acute hospital nursing experience Familiar with Medicare home health regulations, documentation requirements, ICD-10 coding and PPS… more
- SUNY Upstate Medical University (Syracuse, NY)
- …of certification must be consistent with practice). Must have NPI number and be Medicare Enrolled with Medicare Identification Number (or PTAN) OR be eligible ... for Medicare Enrollment within 6 months of hire (eligibility criteria for NP requires National Certification through AANP or ANCC, and Master's Degree) (eligibility… more
- SUNY Upstate Medical University (Syracuse, NY)
- …of certification must be consistent with practice). Must have NPI number and be Medicare Enrolled with Medicare Identification Number (or PTAN) OR be eligible ... for Medicare Enrollment within 6 months of hire (eligibility criteria for NP requires National Certification through AANP or ANCC, and Master's Degree) (eligibility… more
- Trinity Health (Clive, IA)
- …potential financial impact on the member organizations of major changes in Medicare and Medicaid policies. Assists in related advocacy efforts regarding such ... adhere to federal, state and other third-party reimbursement regulations. Prepares Annual Medicare , Medicaid, Blue Cross and Tricare cost reporting for the Trinity… more
- WellSpan Health (York, PA)
- …requests, Pa Health Care Cost Containment Council financial data reporting and Medicare Provider enrollment and change reporting. + Independently compiles data for ... maintaining staff time records. + As part of the Medicare annual cost reporting process, works with employed physicians...of physician time studies to optimize reimbursement from the Medicare program related to Medical Education Programs. + Trains… more
- CenterWell (Boynton Beach, FL)
- …Medicine or Geriatric Medicine preferred . Active and unrestricted DEA license . Medicare Provider Number . Minimum of two to five years directly applicable ... experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best...environment in a value-based relationship environment . Knowledge of Medicare guidelines and coverage . Knowledge of HEDIS quality… more
- Catholic Health Services (Rockville Centre, NY)
- …discharge planners and primary care providers to ensure continuity of care. Medicare Annual Wellness Visit (AWV) Management + Manage and maintain databases of ... Medicare patients eligible for AWVs. + Conduct telemedicine AWVs,...population health, or primary care preferred. + Experience with Medicare Annual Wellness Visits, transitional care, and chronic care… more
- Amergis (French Camp, CA)
- …InterQual assessments + Collaborating with multidisciplinary teams + Applying current Medicare guidelines + Clinical documentation and critical thinking ?? Required ... experience + Utilization Review experience + InterQual experience + Knowledge of Medicare guidelines + Experience with PERFORMANT or CDCR denials (preferred) ??… more
- CenterWell (San Antonio, TX)
- …a part of our Tuberculosis (TB) screening program.** **Preferred Qualifications:** ** Medicare Provider Number** **Medicaid Provider Number** **Minimum of two to five ... years directly applicable experience preferred** **Experience managing Medicare Advantage panel of patients with understanding of Best Practice in coordinated care… more