- CVS Health (Buffalo Grove, IL)
- …interpreting drug information to support UM. Knowledge of regulations impacting UM for Medicare , Medicaid and Exchange clients is preferred. It will be necessary to ... create clinical content for all business segments (Commercial, Medicare , Medicaid and Marketplace) including standard and client requested programs with the ability… more
- WMCHealth (Valhalla, NY)
- …& Quality Assurance: + Ensure all activities are compliant with HIPAA, Medicare /Medicaid billing regulations, and the 340B Drug Pricing Program + Participate in ... & Quality Assurance: + Ensure all activities are compliant with HIPAA, Medicare /Medicaid billing regulations, and the 340B Drug Pricing Program + Participate in… more
- AmeriHealth Caritas (Lancaster, PA)
- …and across the AmeriHealth Caritas organization (Pennsylvania Medicaid and Medicare plans, Pennsylvania shared services (Compliance, Regulatory and Communication), ... + Represent CHC at events organized by AmeriHealth Caritas Medicare plans in Pennsylvania. + Hosting Quarterly Advisory Committee...you and your dependents on Day 1, 401(k) tuition reimbursement , and more. Your career starts now. We are… more
- Humana (Indianapolis, IN)
- …processing status and improvement opportunities to markets and Providers. + Partner with Medicare Risk Adjustment (MRA) and vendors to establish data feeds for STARs ... match + Generous Paid Time Off accrual + Tuition Reimbursement + Parent Leave + Go365 perks for well-being...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Penn Medicine (Philadelphia, PA)
- …health plans to ensure Penn Medicine's ability to bill and receive reimbursement for services rendered to patients. Includes understanding and complying with the ... and follows up on managed care exports and/or government payers (DE/PA/NJ Medicare , PA/NJ Medicaid, Rail Road) or Behavioral Health (Perform Care, Community Care… more
- Aveanna Healthcare (Madison, WI)
- …and Vision Benefits for employees at 30+ hours + Tuition Discounts and Reimbursement + PTO, Sick Time, and Paid Holidays Requirements: + Registered Nurse licensure ... in a healthcare setting (home health or hospice) + Medicare Skilled Nursing experience and a basic understanding of...a basic understanding of OASIS As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- Aveanna Healthcare (Trussville, AL)
- …and Vision Benefits for employees at 30+ hours + Tuition Discounts and Reimbursement + PTO, Sick Time, and Paid Holidays Requirements: + Registered Nurse licensure ... in a healthcare setting (home health or hospice) + Medicare Skilled Nursing experience and a basic understanding of...a basic understanding of OASIS As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- WMCHealth (Hawthorne, NY)
- …in compliance with detailed requirements, guidelines, and deadlines of Centers for Medicare & Medicaid Services, National Committee for Quality Assurance (NCQA) in ... Medical Staff Office by identifying, initiating, monitoring, and maintaining Medicaid and Medicare enrollment requirements. + Ensure proper attention is given to all… more
- MedKoder (Mandeville, LA)
- …and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare , Medicaid, and third-party payer guidelines to ensure receipt of ... accurate reimbursement . Physician Coding Auditor is expected to adhere to...guidelines by the AMA, ICD-10-CM coding and guidelines, and Medicare and Medicaid billing policies for professional services. +… more
- Gentiva (Austin, TX)
- …operations, ensuring compliance with state, federal, and accreditation standards (CMS, Medicare , Joint Commission, etc.) + Provide clinical oversight and ensure ... operations leadership + Strong understanding of hospice regulations, compliance, and Medicare conditions of participation + Proven ability to manage teams, budgets,… more