- AdventHealth (Tampa, FL)
- …and support as needed. **The value you'll bring to the team:** Performs Medicare compliance reviews and issues Advance Beneficiary Notices of Noncoverage as ... needed. Creates accurate estimates for patient financial responsibility and collects payments or establishes payment plans. Coordinates with utilization management staff for pre-authorization issues and ensures patients have necessary logistical information.… more
- Sedgwick (Lexington, KY)
- …and laws + Knowledge of medical terminology for claim evaluation and Medicare compliance + Knowledge of appropriate application for deductibles, sub-limits, ... SIR's, carrier and large deductible programs. + Strong oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Strong organizational skills + Strong interpersonal skills + Good negotiation skills +… more
- HCA Healthcare (Conroe, TX)
- …American College of Cardiology, Society of Chest Pain Centers and governmental regulation for Medicare compliance . Manages all CV Data to include ACC, Action and ... STS data registries. **What you will do in this role:** + Develops and supports education to meet all requirements of Chest Pain Accreditation. + Develops and recommends protocol/guidelines for best practice of the cardiac patient across the continuum of care.… more
- Guidehouse (Pell City, AL)
- …orders for completion and ensures all required information is listed. + Completes Medicare Compliance and obtains ABN if necessary. + Knowledge of all ... Federal, State and Local Laws pertaining to insurance rules and regulations. + Utilizes multiple computer systems. + Maintains positive customer service at all times, referring unresolved issues to appropriate supervisor. + Answers telephone calls. Follows… more
- Guidehouse (Birmingham, AL)
- …orders for completion and ensures all required information is listed. + Completes Medicare Compliance and obtains ABN if necessary. + Knowledge of all ... Federal, State and Local Laws pertaining to insurance rules and regulations. + Utilizes multiple computer systems. + Maintains positive customer service at all times, referring unresolved issues to appropriate supervisor. + Answers telephone calls. Follows… more
- US Physical Therapy (York, PA)
- …Previous outpatient orthopedic clinic experience + Exercise and Manual based skills, Medicare compliance responsibilities and Sports Rehab + Outgoing and ... energetic personality **Additional Information** + Great hourly compensation + 401k + Multiple opportunities for Professional Development, Specialization, and Leadership + Family-Friendly Work Environment + Investment from a company that wants you to succeed… more
- Guidehouse (Los Angeles, CA)
- …orders for completion and ensures all required information is listed. + Completes Medicare Compliance and obtains ABN if necessary. + Knowledge of all ... Federal, State and Local Laws pertaining to insurance rules and regulations. + Maintains multiple computer systems. + Maintains positive customer service at all times, referring unresolved issues to appropriate supervisor. + Answers telephone calls. Follows… more
- Highmark Health (Charleston, WV)
- …models. This job is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, hands-on, office ... based support to PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies opportunities for improvement in value… more
- The Cigna Group (Bloomfield, CT)
- …position will provide external actuarial analytics support within the regulated Medicare market and Pharmacy Benefit Manager (PBM) Healthplan space. This actuarial ... a designated full time support to Express-Script's external client's Medicare Part D business. This role will matrix with...Bid Development, Desk Review & Audits + CMS Regulatory Compliance / Reporting + Financial Reconciliation Modeling + Trend… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …with the guidance and plans they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and Medicare Line of Business, ... explaining program benefits in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and regulations. The Medicare… more