- Logan Health (Kalispell, MT)
- …care rooms for safety and cleanliness. + *Assists the RN/LPN with maintaining compliance with Medicare and all applicable regulatory standards. + *Works with ... the RN/LPNs to set and maintain priorities for patient care tasks. + *Adheres to and upholds all organizational customer service policies and standards while caring for patients, their families and interacting with co-workers and physicians. + Other duties as… more
- Logan Health (Kalispell, MT)
- …throughout the therapy process. + Ensure timely and accurate documentation in compliance with Medicare , Medicaid, private insurance, and Montana regulations. + ... Champion customer service excellence, fostering trust and strong relationships with patients and colleagues. + Engage in department initiatives and community programs, furthering Logan Health's mission to serve. What You Bring: + One of the following: + Active… more
- Beth Israel Lahey Health (Plymouth, MA)
- …plans and acts as a liaison between ED and post-acute providers + Ensure compliance with Medicare , Code 44, and reimbursement regulations + Address social ... determinants and high-risk cases in partnership with Social Work + Advocate for safe, patient-centered discharges with strong documentation **Requirements for Both Roles:** + Current RN license in Massachusetts + Minimum 3 years recent acute care experience +… more
- PruittHealth (Norcross, GA)
- …for health plans * Knowledge of CMS required contracting language for Medicare Advantage Plan agreements * Demonstrate compliance with CMS regulations ... and articulate them effectively to providers and teammates. * Complete annual Medicare Fraud, Waste and Abuse Training and Model of Care Training **MINIMUM… more
- Ventura County (Ventura, CA)
- …and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare , and general insurance reimbursement ... but are not limited to, the following: + Ensures accuracy and compliance with billing, coding, and follow-up requirements and identifies overpayments and lack… more
- Cedars-Sinai (CA)
- … Medicare and Medi-cal managed care members are in compliance with program regulations, insurance regulations, and regulatory requirements. + Maintains ... and tracks laws and regulations, contract documentations, amendments, and various compliance measures pertaining to Commercial, Medicare and Medi-cal managed… more
- Henry Ford Health System (Troy, MI)
- …based on trends to maximize the efficiency of the call center productivity. + Ensure compliance with the Centers for Medicare & Medicaid Services (CMS) and other ... of health care delivery systems. + Working knowledge of Medicare Advantage Programs. + Knowledge of CMS Compliance... Medicare Advantage Programs. + Knowledge of CMS Compliance regarding customer satisfaction. + HMO health care concepts.… more
- AmeriHealth Caritas (Lancaster, PA)
- …"CHC") and across the AmeriHealth Caritas organization (Pennsylvania Medicaid and Medicare plans, Pennsylvania shared services ( Compliance , Regulatory and ... and ensures activities are carried out within company, state, and CMS compliance rules and regulations. **Work Arrangement:** Remote with required travel in the… more
- MedKoder (Mandeville, LA)
- …services including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare , Medicaid, and third-party payer ... Surgery, Peds NICU/PICU, and FQHC/RHC. Responsibilities: + Perform professional compliance audits of coding and documentation including surgeries, visits, and… more
- Redeemer Health Home Care & Hospice (Meadowbrook, PA)
- …and Pathophysiology/Disease Processes/Pharmacology required. . Works claim edits identified along with compliance of the Medicare Coverage Determinations ( MCD ) ... ICD-10 and CPT-4 guidelines, UHDDS sequencing guidelines, CMS coding guidelines, Medicare and Medicaid regulations and the American Hospital Association coding… more