- 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-Valley **Position Overview:** This position conducts review of outpatient medical records using International Classification of… more
- Northwell Health (Westbury, NY)
- …Federal and State regulations. 5.Applies coding rules and regulations to the validation review process. 6.Reviews codes on Medicare /non- Medicare charts for ... clinical expertise to identify and validate DRG code assignment. 2.Full review of CDI suggested code changes 3.Demonstrates comprehensive knowledge of coding… more
- HonorHealth (AZ)
- …a detailed internal budget for studies in accordance with the protocol, the Medicare coverage analysis, and internal pricing guidance. Review and update the ... competencies include project management, clinical trial operations, coding/billing compliance, Medicare coverage analysis/budgeting, contracting, Clinical Trial Management Systems (CTMS),… more
- Merck (Rahway, NJ)
- …including our Company's Annual Enrollment, Retiree Health Exchange and the Medicare Open Enrollment, compliance, call center excellence and benefit communications. ... programs at critical moments in their career lifecycle (ie retirement, separation) + Review , research and respond to employee and retiree issues to ensure a seamless… more
- Amgen (Chicago, IL)
- …through payer prior authorization to appeals/denials requirements and forms. + Review patient-specific information in cases where the site has specifically requested ... to HCPs on how the products are covered under the benefit design (Commercial, Medicare , Medicaid). + Serve as a payer expert for defined geography and promptly… more
- CVS Health (Salt Lake City, UT)
- …**Key Responsibilities** : + Drafting and reviewing product filings: Draft Medicare Supplement and short-term limited duration health insurance products (policies, ... Stay abreast of changes in state and federal regulations related to Medicare supplement insurance. + Record Keeping: Maintain accurate records of product filings… more
- CareOregon (Portland, OR)
- …on the satisfactory completion of a pre-employment background check, immunization review , and drug screen (including THC/Marijuana). CareOregon is a federal ... with enrollment assistance at Oregon Health Plan (OHP) and Medicare 'pop up' locations such as food banks, homeless...member customers, ensure compliance standards are met, and consistently review procedures for HIPAA and other legal compliance. +… more
- CenterWell (Tallahassee, FL)
- …several nurse practitioners or physician assistants, including completing regular chart review , coordinating monthly meetings, and being readily available to help ... * Meet with medical leader about quality of care, review of outcome data, policy, procedure, and records issues....Geriatric Medicine * Active and unrestricted DEA license * Medicare Provider Number * Medicaid Provider Number * Excellent… more
- Northwell Health (Westbury, NY)
- …hospital's charge description master. + Oversees and assists in the resolution of Medicare / Medicaid edits generated on hospital outpatient and inpatient Part B ... and maintenance of the charge master and charging philosophy. + Ensures timely review of regulatory literature such as the Federal Register, Medicare … more
- Amgen (Philadelphia, PA)
- …through payer prior authorization to appeals/denials requirements and forms. + Review patient-specific information in cases where the site has specifically requested ... to HCPs on how the products are covered under the benefit design (Commercial, Medicare , Medicaid). + Serve as a payer expert for defined geography and promptly… more