- Amentum (Baltimore, MD)
- …by the federal government to identify anomalies that might be indicative of improper billing or other types of fraud. + Initiate contacts with federal, state, and ... local officials, and other organizations, including Medicare and Medicaid contractors, related to the subject of the investigation for the purpose of gathering… more
- Pine Acres Rehabilitation & Care Center (Nebraska City, NE)
- …facility. Complies with facility policies and procedures for appropriately documenting, billing and coding for residents receiving speech language pathology and ... as required by facility policy (RAI User's Manual) for Medicare Part A, Medicare Advantage residents upon admission. Ensures speech language pathology and… more
- Genesis Healthcare (Fredericksburg, VA)
- …the MDS, as required by federal and state regulations. *Manage all Medicare /Medicaid case-mix documents at the nursing center to assure appropriate reimbursement for ... *Communicate with the Business Office Manager regarding case-mix data required for billing . *Educate the interdisciplinary team on case-mix and the nursing staff in… more
- Houston Methodist (Houston, TX)
- …care payers include commercial payers, separate transplant contracts, Medicare Advantage, Medicaid Health Maintenance Organizations (HMOs), International, behavioral ... to finance, accounting, operations teams regarding interpretation of contracts and applied billing . + Utilizes a thorough understanding of managed care operations to… more
- University of Miami (Doral, FL)
- …and Conditions of Admissions, Advance Directives, HIPAA Notice of Privacy, No Surprise Billing , Good Faith Estimate, Off Campus Medicare Co-insurance and Advance ... Beneficiary Notices, and Medicare Secondary Payer Questionnaire. + Serves as gatekeeper, performs insurance verification, and obtains referrals and/or authorizations as needed. + Provides financial counseling services at check-in, explains benefits,… more
- WMCHealth (Hawthorne, NY)
- …in compliance with detailed requirements, guidelines, and deadlines of Centers for Medicare & Medicaid Services, National Committee for Quality Assurance (NCQA) in ... enrollment databases/rosters, ensuring all information is current and accurate for billing and credentialing purposes. + Requests documentation follows up on receipt… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …will be considered. * Experience in medical coding with a focus on Medicare Advantage and ACA risk adjustment. * Certified Risk Adjustment Coder (CRC) certification ... * In-depth knowledge of ACA & Medicare Advantage risk adjustment methodology, coding guidelines (ICD-10-CM), healthcare compliance, and billing practices. *… more
- UHS (Binghamton, NY)
- …Prepare and submit timely, well-documented appeals for denied services to Medicare , Medicaid, and commercial payers, including Insurance Reviewers, Hearing Officers, ... are billed under the correct admission status and that documentation supports billing requirements. + Partner with physician and hospital coders to ensure accurate… more
- New York State Civil Service (Jamaica, NY)
- …projections, capital outlay and fixed assets schedules, and Medicaid & Medicare reimbursement activities for the facility.* Develops, implements, reviews, and ... Qualifications: This challenging opportunity requires competence in: i) preparing Medicare and Medicaid cost reports for healthcare facilities; ii) utilizing… more
- New York State Civil Service (Batavia, NY)
- …projections, capital outlay and fixed assets schedules, and Medicaid & Medicare reimbursement activities for the facility.* Develops, implements, reviews, and ... Qualifications: This challenging opportunity requires competence in: I) preparing Medicare and Medicaid cost reports for healthcare facilities; II) utilizing… more