- AdventHealth (Maitland, FL)
- …insurance requirements. + Verifies medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards by reviewing guidelines and ... role you'll contribute:** The Pre-Access Infusion Benefits and Authorization Specialist , under general supervision, maintains performance standards appropriate to… more
- Trinity Health (Livonia, MI)
- …required modifiers. Utilizes coding guidelines established by: + The Centers for Medicare / Medicaid Services (CMS) ICD-CM Official Coding Guidelines for Coding ... and Patient Business Services (PBS) teams, when needed, to help resolve billing , claims, denials and appeals issues affecting reimbursement. Exhibits awareness of… more
- Mohawk Valley Health System (Utica, NY)
- …clinical variability throughout the medical staff. + Assist case managers with Medicare and Medicaid appeals and Administrative Law Judge (ALJ) testimonies. ... Managers and Attending Physicians to align on the level of care, patient billing status, and potential barriers to patient discharge. The Physician Advisor (PA)… more