- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …system, needs assistance with home modifications/care at home, needs information about Medicare / Medicaid ). * Screens members for social/emotional factors such as ... experience. * 1 year of county or hospital social work experience. * Medicare and/or Public Programs experience. * Flexibility to work varied hours. * Demonstrates… more
- Ochsner Health (New Orleans, LA)
- …Knowledge of heath care systems and public programs such as those funded by Medicare , Medicaid , Medicare Advantage, and commercial insurance plans. + Strong ... interpersonal skills necessary to deal effectively and courteously with patients, families, multidisciplinary team members, departmental peers, and community agency personnel. **Job Duties** + Conducts patient assessment interviews, provides referrals and… more
- Scripps Health (San Diego, CA)
- …of healthcare EPIC software preferred. * Minimum two year experience billing Medicare , Medicaid , Blue Cross and Commercial insurance preferred, three or ... Payers and payer requirements. * Knowledge of Medical Terminology and Medicare Compliance. * Familiarity with HIPAA privacy requirements for patient information.… more
- United Methodist Communities (Ocean City, NJ)
- …restorative, rehabilitation and physician services to ensure appropriate reimbursement for Medicare / Medicaid residents. Requirements for an MDS Coordinator: + ... to assure it accurately reflects resident status and maximize reimbursements for Medicare A residents. Monitors the overall process and tracking of RAI/MDS… more
- Truman Medical Centers (Kansas City, MO)
- …+ Knowledge of insurance company, third-party and government reimbursement programs; ie Medicare , Medicaid , MC+, etc. + Knowledge of medical insurance billing ... software systems, programs and devices. + Ability to maintain knowledge of Medicare rules and Local Carrier Determination (LCD) and national Correct Coding… more
- Humana (Bismarck, ND)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... 2+ years of actuarial experience in healthcare + SAS or other coding skills + Medicare experience + Familiarity with CMS Star Ratings Travel: While this is a remote… more
- CVS Health (Austin, TX)
- …Qualifications** + Pharmacist + 7-10 years work experience in healthcare + Medicare and/or Medicare - Medicaid Integrated Product Experience + Experience ... with Part D Coverage Determination, Appeals and Grievances and/or Formulary Administration regulatory requirements and audit management + Experience with Part C & D reporting requirements + 3+ years serving as project lead + Adept at problem solving and… more
- Houston Methodist (The Woodlands, TX)
- …by capacity to prioritize multiple tasks and role components + Knowledge of Medicare , Medicaid and Managed Care requirements + Comprehensive knowledge of ... if needed, and informs management of the possible need for issuing Medicare Hospital Initiated Notice of Non-coverage. + Applies approved utilization criteria to… more
- Alameda Health System (Alameda, CA)
- …7. Assigns, assists, and instructs all staff in the RAI Process, Case-Mix, PPS Medicare , Medicaid , and the clinical computer system in relation to these ... is documented and a resolution is initiated and presented weekly at Medicare or Utilization Review meetings. **MININUM QUALIFICATIONS** : Education: Graduate of… more
- US Tech Solutions (Wichita, KS)
- …HAVE MEDCOMPASS or ASSURECARE exp. + MUST HAVE MANAGED CARE exp and Medicare / Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management ... of Care cases across all lines of business (Commercial and Medicare ). + Independently coordinates the clinical resolution with internal/external clinician support… more