- Covenant Health Inc. (Knoxville, TN)
- …+ Demonstrates knowledge of State and Federal regulations, HCFA guidelines, HIPAA, Medicare / Medicaid guidelines and other Third Party Payor requirements assuring ... provides training for new or revised rules ensuring compliance with HCFA Tenncare/ Medicaid or other State or Federal regulations. + Resolves complex collection… more
- ChenMed (Miami, FL)
- …AND ABILITIES:** + Strong business acumen and acuity + In depth knowledge of Medicare , Medicaid , and commercial billing rules and regulations, coding, and ... role assists with the strategic alignment and oversight of claims assembly and submission processes. In close collaboration with...reimbursement processes + Comprehensive knowledge of Medicare … more
- Queen's Health System (Honolulu, HI)
- …delivery systems, including contracting and financial analysis. o Knowledge of reimbursement regulations, including Medicare / Medicaid program requirements, ... maintenance, claims submission and follow-up, payment posting, collections, claims adjudication, third party payer contracts, government reimbursement and… more
- Philips (Malvern, PA)
- …applying Anti-Kickback Statute (AKS) considerations, Centers of Medicaid and Medicare Services (CMS) regulations, claims audits, billing, coding, revenue ... to the Company on issues facing sales, services, billing and reimbursement , and interactions with healthcare providers and professionals. Also, you will… more
- Centene Corporation (Queens, NY)
- …and executive orders. + Deep understanding of managed care models (HMO, PPO, Medicaid , Medicare Advantage, Duals, SNPs). + Familiarity with healthcare laws, ... reimbursement models, and value-based care initiatives. + Perform duties...related to operational areas. + Oversee day-to-day operations including claims processing, provider network management, member services, utilization management,… more
- Prime Healthcare (Sherman Oaks, CA)
- …language 6. Working experience with all payer types including: commercial, governmental, Medicare , Medicaid , HMO, etc. and the ability to cross-over into ... Outstanding Medical + Dental + Vision coverage + Tuition reimbursement + Many more voluntary benefit options! (https://www.primehealthcare.com/careers/benefits/) Benefits… more
- Catholic Health Initiatives (Little Rock, AR)
- …CIN. + Educate providers to improve documentation and coding practices, for accurate claims submissions and accurate reimbursement . + Continue to work closely ... Value Based Agreements (VBAs) with governmental (CMS and state for Medicare Shared Savings-Accountable Care Organization/MSSP-ACO and Medicaid ), private insurers… more
- Queen's Health System (Honolulu, HI)
- …I. JOB SUMMARY/RESPONSIBILITIES: * Responsible for analysis of denied reimbursement claims , including conducting payment audits, creating reports ... Representative in an acute care facility, demonstrating good working knowledge of Medicare , Medicaid , Third Party payor requirements. SNF/ICF, ICD-9/ICD-10 and… more
- HCA Healthcare (Overland Park, KS)
- …a liaison accounts and administer contracts in collection of third party accounts ( Medicare and Medicaid ) + You will complete account reconciliation of accounts ... and self-pay accounts to enhance cash flow and gather reimbursement based on established contracts. **What you will do...work to correct them + You will monitor insurance claims and contact insurance companies to resolve claims… more
- Centene Corporation (Helena, MT)
- …and guidelines established by the American Medical Association and the Centers for Medicare and Medicaid Services. + Analyze provider billing practices by ... with coding practices through a comprehensive review and analysis of medical claims , medical records, claims history, state regulations, contractual obligations,… more