- Trinity Health (Howell, MI)
- …diagnosis, procedure, date, and physician signature to minimize risk to hospital reimbursement . Accurately uses the patient search feature to find the correct ... and skills competencies such as the Certified Revenue Cycle Specialist Professional (CRCSP) through the American Association of Healthcare Administrative… more
- CareFirst (Baltimore, MD)
- …role will also oversee complex projects related to provider contracts, reimbursement methods, documentation and amendments, and participate in internal workgroups ... a consultant and subject matter expert (SME) in contracting and reimbursement , offering insights during contract development and negotiations with smaller provider… more
- AdventHealth (Altamonte Springs, FL)
- …record, applying appropriate ICD-10-CM/PCS coding conventions and MS-DRG Medicare Prospective Payment System requirements. Actively participates in outstanding ... ICD-10-CM rules and conventions, coding policy and procedures, requirements of Medicare / payer specifications, and official coding guidelines as outlined by… 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
- Brockton Hospital (Brockton, MA)
- …profiling, and reimbursement . + Knowledge of pathophysiology and disease process; Medicare Part A and B knowledge of regulatory environment. + Understanding and ... ability to communicate the differences between Medicare Part A and Part B guidelines and how they impact DRG assignments. + Organizational, analytical, writing, and… more
- Diversicare Healthcare Services & Diversicare Ther (Huntsville, AL)
- …is the _Diversicare Difference_ . \#BSC123 **Responsibilities** The key role of the Clinical Reimbursement Specialist is to ensure that the RAI process at each ... expectations, which are not all-inclusive, will guide the Clinical Reimbursement Specialist : 1. Train and consult with...and consult with RNACs and MDSCs on the RAI, Medicare , Medicaid and Managed Care processes to facilitate compliance,… more
- AdventHealth (Orlando, FL)
- …record, applying appropriate ICD-10-CM/PCS coding conventions and MS-DRG Medicare Prospective Payment System requirements. Actively participates in outstanding ... physicians and clinical personnel to ensure optimal coding and reimbursement , querying physicians for the clarification of discrepancies, additional diagnoses,… more
- City of New York (New York, NY)
- …-Retiree health benefits enrollment/change applications -Inquiries regarding payments under the Medicare Part B Reimbursement Program, which also includes the ... Income Related Monthly Adjustment Amount (IRMAA) reimbursement -Health coverage for the domestic partners of both active employees and retirees -The resolution of… more
- Sharp HealthCare (San Diego, CA)
- …initiatives that support pharmaceutical contracting, procurement, distribution, utilization and reimbursement in the hospital and ambulatory care settings resulting ... **Preferred Qualifications** + 3 Years experience with managed care, PBM and/or Medicare Part D, Medicaid, Commercial Health Insurance. + Experience with Oncology… more
- Fairview Health Services (St. Paul, MN)
- …and communicate/deliver notices of non-coverage to patients (ex: HINN, ABN, waiver, Medicare lifetime reserve days). + Follow up with payers on active authorized ... and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement , retirement, early access to earned wages, and more! Please follow this… more