- Alameda Health System (Oakland, CA)
- …the American College of Radiology (ACR), The Joint Commission (TJC), Centers for Medicare & Medicaid Services (CMS), and the California Department of Public Health - ... and provide education on data quality and downstream impacts on billing , quality reporting, and accreditation. **7. Data Analytics, Reporting & Standardization**… more
- Option Care Health (Baton Rouge, LA)
- …nutrition, + immunology/neurology, oncology, or transplant. + Basic understanding of billing and reimbursement procedures for hospital, medical offices, and ... Medicare (B/D + benefits) as well as medical offices. + One year experience directly managing people including hiring, developing, motivating, and directing + people… more
- Dignity Health (Rancho Cordova, CA)
- …adhering to a standardized approach, the Denials RN ensures accurate billing , promotes financial stewardship, and champions patient advocacy, ultimately contributing ... information and to share denial trends and gaps in process. + Performs Medicare short stay reviews and validation as assigned. + Develops, reviews, and recommends… more
- Zelis (FL)
- …with providers + Experience and working knowledge of Health Insurance, Medicare guidelines and various healthcare programs + Understanding of hospital coding ... and billing rules + Clinical skills to evaluate appropriate Medical Record Coding + Experience conducting root cause analysis and identifying solutions + Strong… more
- HCA Healthcare (Nashville, TN)
- …and Southern Joint Surgery Center. This entails financial analysis and management, cash flow, billing and collections. Your goal is to manage the flow of work with ... + You will oversee center managed care contracts with third party payers including Medicare and Medicaid **What you should have for this role** + Bachelors degree in… more
- Sharp HealthCare (San Diego, CA)
- …for confidentiality and HIPAA guidelines. Documentation meets allthird-party payer ( Medicare , PPO, Work Comp and HMO) and regulatory requirements.Completes all ... notes and billing daily.Completes all tasks and documentation needs (ie utilization management, plan of care, medical necessity reviews) based on department and… more
- The Cigna Group (Bloomfield, CT)
- …not limited, to those within Commercial, Health Care Exchanges and Medicare Part-D lines of business. Such responsibilities include: + Self-sufficient experienced ... savvy with SFTP (Secure File Transmission Protocol), file layouts, claim adjudication, billing and invoicing + Participates and/or leads willingly on internal work… more
- Virtua Health (Pennsauken, NJ)
- …denial management in the case management documentation system and in the billing system.Denial Management* Manages the concurrent denial process by referring to ... experience and 1 year UR/CM/QM experience preferred.Basic understanding of Medicare , Medicaid and managed care.Discharge planning or home health background.Excellent… more
- UTMB Health (Pearland, TX)
- …counseling for day surgery . Educates patient/responsible parties regarding the billing process and any additional financial responsibilities including third party ... information required for third party reimbursement. . Ensures compliance with Medicare and third-party coverage. . Communicates with patient, referral source, UTMB… more
- Houston Methodist (Sugar Land, TX)
- …also performs the medical necessity check, to ensure compliance with Medicare guidelines. The Patient Access Associate position employs effective communication ... and physicians. Ensures that the correct insurance plan codes are utilized for the billing process. + Explains the consent forms, obtains signatures on the forms and… more