- Fallon Health (Worcester, MA)
- …strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid , and PACE (Program of All-Inclusive Care for the ... SLA's. With speed, accuracy, and integrity, ensures that enrollee data for Medicare Advantage, Medicare Supplement, NaviCare, Summit Elder Care, Fallon Health… more
- Humana (Tallahassee, FL)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... in alignment with regulatory and accreditation standards, including CMS and Medicare Advantage requirements. The manager also prepares the organization for… more
- Humana (San Juan, PR)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... coding languages such as SAS and SQL + Prior Medicare Advantage or health insurance background + Additional skills...role provides a unique opportunity to get hands on Medicare Advantage experience in a rapidly growing area outside… more
- Houston Methodist (Houston, TX)
- …knowledge of local and national coverage determinations + Comprehensive knowledge of Medicare , Medicaid , and Managed Care requirements + Comprehensive knowledge ... of Non-Coverage (HINN), Ambulatory Benefit Notice (ABN), Important Message from Medicare (IMM), Medicare Outpatient Observation Notice (MOON), and Condition… more
- Prime Therapeutics (Oklahoma City, OK)
- …specialized needs of the targeted population; for Medicare , is Centers for Medicare & Medicaid Services (CMS) compliance compliant + Utilize Prime's MTM ... operations (eg workflow processes and case management) + Government programs ( Medicare ) knowledge **Preferred Qualifications** + Contact Center experience + Pharmacy… more
- CenterWell (Safety Harbor, FL)
- …Medicine or Geriatric Medicine preferred . Active and unrestricted DEA license . Medicare / 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 environment in a… more
- Corewell Health (Farmington Hills, MI)
- …motivated and reach their goals. Our Dementia Care floor is a 60 bed Medicare / Medicaid /Dementia unit. We provide care to residents with a variety of diagnoses. ... the unit Our sub-acute floor is a 59 bed Medicare unit that has residents with multiple clinical issues...satisfaction. Our Chronic Care floor is a 60 bed Medicare /Rehabilitation and long-term care unit and is a great… more
- Stony Brook University (Stony Brook, NY)
- …performing billing processes and troubleshooting billing questions according to NYS DOH, Medicare , Medicaid and patient insurance regulations. d. Monitors the ... bills (invoices). Ensures tests are ordered, performed, and billed per Medicare /OIG regulations. f. Audits all test credits performed in Specimen Receiving… more
- Humana (Corpus Christi, TX)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... Auditor ensures clinical documentation meets CMS regulations, OASIS accuracy, and Medicare Conditions of Participation. This role audits Start of Care,… more
- Pine Acres Rehabilitation & Care Center (Fairfield, IA)
- …provide the service. This ensures the most accurate documentation. We are a Medicare / Medicaid certified home health agency and meet all Conditions of ... Participation (CoP's) per Medicare requirements. PRIMARY RESPONSIBILITIES: + Plan of Care: Provide skilled physical therapy as ordered by the attending physician and… more