- Evolent (Helena, MT)
- …under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid , and is not identified as an "excluded person" by ... Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or legal action by a state… more
- Centene Corporation (Austin, TX)
- …+ Develops, enhances and maintains provider relationship across all product lines ( Medicare , Medicaid , Ambetter). Supports the development and implementation of ... Providers and Systems), HOS (Health Outcomes Survey), CTMs (Complaints to Medicare ), Disenrollments, Appeals, and Grievances. + Collaborates with Provider Relations… more
- Centene Corporation (Little Rock, AR)
- …Develops, enhances and maintains provider relationship across all product lines ( Medicare , Medicaid , Ambetter). Supports the development and implementation of ... and Systems), HOS (Health Outcomes Survey), CTMs (Complaints to Medicare ), Disenrollments, Appeals, and Grievances. Collaborates with Provider Relations and… more
- Actalent (Little Ferry, NJ)
- …knowledge. + Data entry skills. + Insurance knowledge. + Experience with Medicare , Medicaid , and private insurance verification. + Strong multitasking abilities. ... Bright Tree System to navigate NJ HMO websites, commercial insurance portals, and Medicare systems. + Contact insurance providers to verify benefits and coverage. +… more
- Intermountain Health (Grand Junction, CO)
- …(PPS) ensures accurate scoring of functional status in accordance with Center for Medicare & Medicaid Services (CMS) guidelines. In addition, the PPS Coordinator ... submission to CMS and/or other auditors, as needed. + Maintains knowledge of current Medicare rules pertaining to the IRF including the annual final rule and related… more
- Humana (Denver, CO)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... reporting on progress, challenges, and achievements to management. + Partner with Medicare Risk Adjustment (MRA) and vendors to establish data feeds for STARs… more
- Elevance Health (Indianapolis, IN)
- …Pharmacy Care Center (CPCC) is a clinical pharmacy call center that services Medicare , Medicaid , and the Commercial member populations. The members we reach ... authorization requests from physicians' offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization… more
- State of Colorado (Rio Grande County, CO)
- …banking, petty cash, and donation accounts + Overseeing/completing regular billings for Medicare , Medicaid , Hospice, the Department of Veterans Affairs, Managed ... name check and fingerprint check, ICON Colorado court database, Medicare fraud database, Reference Checks, Professional License verification (licensure… more
- Huron Consulting Group (Chicago, IL)
- …(CDC), ICD-CM Official Coding Guidelines for Coding and Reporting, Centers for Medicare / Medicaid Services (CMS) ICD-PCS Official Guidelines for Coding and ... secondary diagnoses, principal procedure and secondary procedures. Assigns appropriate Medicare Severity Diagnosis Related Groups (MS-DRG), All Patient Refined DRGs… 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. ... environment + CNA or Medical Assistant experience + Quality experience + Medicare experience + Familiarity with medical terminology and/or ICD-10 codes **Additional… more