- University of Michigan (Ann Arbor, MI)
- …credentialing, and privileging following the strict requirements of Centers for Medicare and Medicaid (CMS), The Joint Commission (TJC), the ... appropriate, by applying expert knowledge, expertise, and experience. Acting as a specialist in the complex Michigan Medicine credentialing process has the authority… 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
- State of Connecticut, Department of Administrative Services (Waterbury, CT)
- …regulations and Joint Commission on Accreditation of Healthcare organizations standards, Medicare and/or Medicaid regulations, Public Health Code standards and ... + Assist in chart audits, quality assurance audits, and billing audits; and + Develop policies and procedures to...have been at the level of a Medical Records Specialist 2 or its equivalent. + Certification as a… more
- United Musculoskeletal Partners (Golden, CO)
- …the chart. * Review all necessary authorizations and medical necessity as required by Medicare , Medicaid , or commercial insurance to fit and bill for each ... cost center. Assists with supplies surrounding injectables and DME products. The DME Specialist is responsible for all matters concerning DME patient care and retail… more
- Commonwealth Care Alliance (Boston, MA)
- …Mentoring subject matter expert of the team + Managed Care experience (preferably Medicare / Medicaid ) + Experience in health plan provider relations + Experience ... Engagement & Performance **Position Summary:** The Senior Provider Relations Specialist is responsible for building, maintaining and strengthening relationships with… more
- Commonwealth Care Alliance (Boston, MA)
- …experience + Experience in health plan provider relations. **Experience (Desired)** + Medicare / Medicaid experience preferred. + Experience with CPT coding and ... provider community. In this highly visible field position, the provider relations specialist acts as the primary liaison between CCA and its providers including… more
- Centene Corporation (Jefferson City, MO)
- …and guidelines established by the American Medical Association and the Centers for Medicare and Medicaid Services. + Ensures Payment Integrity DRG Review ... with all policies and standards **Education/Experience:** Associate's Degree in Medical Billing and Coding, Healthcare or related field, or equivalent experience… more
- Banner Health (AZ)
- …compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the ... residents, heavy EM coding and inpatient visits sometimes involving split billing . **Shift: Monday-Friday, 7:30-4; 8am-4:30 with flexibility** **Ideal Candidate:** +… more
- General Dynamics Information Technology (Fairfax, VA)
- …As a Healthcare Coding Subject Matter Expert (SME) supporting the Centers for Medicare and Medicaid (CMS), you will be trusted to research healthcare ... Ancillary Health **Skills:** Healthcare Fraud (Inactive),Insurance Fraud Investigations,Insurance Regulations,Medical Billing and Coding,Technical Writing Documentation **Certifications:** Certified Professional Coder… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- …insurance eligibility and benefits through various payers, including commercial insurances, Medicaid , and Medicare . + Obtains the necessary prior authorizations, ... due on the account. + Educates the patient/responsible parties regarding billing processes, financial responsibilities, third party benefit information and, provides… more