- Humana (Indianapolis, IN)
- …in navigating multiple computer tools/systems/screens + 2+ years of Medicare customer service experience or sales experience (virtual/telephonic preferred) + ... Demonstrated ability to understand and explain Medicare benefits and address the unique needs of ...protection. Please be aware that applicants selected for leader review may be asked to provide their social security… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …functions, including but not limited to, regulatory and D-SNP contract review and interpretation, periodic monitoring and auditing activities based on established ... with our business partners, the State Medicaid Office and/or the Centers for Medicare and Medicaid Services (CMS). The Compliance Manager will work closely with… more
- Ventura County (Ventura, CA)
- …for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare , and general insurance reimbursement requirements. The ideal candidate possesses ... medical billing or a related field. + Experience in Managed Care/Medicaid/ Medicare and/or Commercial Insurance billing. + Experience with multiple Electronic Health… more
- Intermountain Health (Juneau, AK)
- …HIM, PAS, and hospital finance staff as needed. + Prepares monthly Medicare and Medicaid settlement and policy reserve calculations using technically acceptable and ... and exception requests to appropriately maximize reimbursement. Interacts with Medicare Administrative Contractor, State Medicaid, and hospital personnel as needed.… more
- BAYADA Home Health Care (Bethlehem, PA)
- …Physical Therapist or Occupational Therapist should have prior experience in Medicare Home Health. This position offers the successful candidate the opportunity ... and quality clinical care + Ensure adherence to policies and procedures + Review clinical documentation, including OASIS and care plan coding + Monitor episodic… more
- Providence (Renton, WA)
- …training, job aides and technical support for caregivers regarding Centers for Medicare and Medicaid Services (CMS) Medicare Secondary Payer reporting, ... + Act as a resource to fellow caregivers for Medicare Secondary Payer reporting of third-party claim payments and...focus topics to claims leaders based on trending analysis. Review claim files from a quality assurance perspective to… more
- PruittHealth (Blue Ridge, GA)
- …annual and significant change assessments as well as any required Medicare assessment. Responsibilities include maintaining accurate and timely assessments, meeting ... patient's care plan prior to administering care. 11. Coordinates the review of each assessment/care plan for accuracy (including timeliness appropriate signatures… more
- Elara Caring (Opelousas, LA)
- …locations to meet patient needs. + Ensures compliance of current Medicare , Medicaid, and third-party reimbursement regulations and changes. Identifies and reports ... potential payment/coverage problems. + Supervises and coordinates utilization review activities. + Participates in strategic development of Key Accounts, including… more
- Heritage Ministries (Conneautville, PA)
- …pre-admission notes and face sheet, and the primary insurance coverage (other than Medicare ). Verifies the Medicare benefit and coverage as well as benefits ... insurances. (Admissions will obtain pre-authorization for primary insurances other than Medicare ). Obtains copies of the resident's insurance cards, POA or… more
- Sutter Health (Sacramento, CA)
- …ensure accurate assignment of medical diagnoses and procedures. Responsible for pre-appointment review of each encounter in scope, including Medicare Advantage ... SHSO-Sutter Health System Office-Bay **Position Overview:** This position conducts review of outpatient medical records using International Classification of Disease… more