- Medical Mutual of Ohio (Brooklyn, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Medical Mutual' s ... alternatives and solutions.Documents exceptions to architectural standards. + Assists in the review and revisions of new and existing IT standards and policies… more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... Acknowledgement of Receipt of Privacy Practices, Questionnaires, Important Message from Medicare , + Advance Directives Checklist, and answer any questions patients'… more
- Fresenius Medical Center (Kennesaw, GA)
- …teams to assure proper direction is obtained. + Assuring compliance with Medicare /Medicaid requirements and regulations by: + Maintaining current knowledge on ... Medicare , Federal, State and local regulations including reimbursement and...Manager, assuring proper chart documentation is established. + Physician, review of policies regarding chart/charge sheet. + Monitors adherence… more
- New York State Civil Service (Binghamton, NY)
- …or family therapy; crisis intervention, consultation to other agencies; training and peer review .In addition to the above duties, you may also perform the following ... or release to strict and intensive community supervision and treatment; develop, review , and oversee behavior management plans and/or treatment plans; and develop… more
- Central Maine Medical Center (Rumford, ME)
- …implements, and evaluates the needs of patients for discharge planning and utilization review . This includes those who may have Medicare , Medicaid, HMO, or ... have an ongoing caring relationship with the patient. Utilization review procedures include those stated for discharge planning in...discharge planning in addition to knowledge of criteria for Medicare , Medicaid coverage and that of HMO or private… more
- Walworth County (Elkhorn, WI)
- …of activities in order to create claims for insurance, Medicaid, Medicare and consumer self-pay statements. SCHEDULE Division: Administration Days: Monday - ... Health Record (EHR) daily to assure that medical billing records are accurate. Review appropriate client and/or billing reports to find and fix errors to ensure… more
- Whidbey General Hospital (Coupeville, WA)
- …and background to assure compliance with CMS Conditions of Participation regarding Utilization Review and Discharge Planning. The RN - Care Manager will lead an ... hospital's Case Management/Utilization Plan that integrates the functions of utilization review , discharge planning, and resource management into a singular effort… more
- Point32Health (Canton, MA)
- …and state regulations for applicable lines of business (Corporate, Commercial, Medicare , Duals and/or Medicaid). This work requires partnering with internal ... regulatory audits to ensure timely completion of data and documentation collection, review , and submission. Perform review of regulatory audits results. Support… more
- CVS Health (Franklin, TN)
- …each and every day. **Position Summary** The Team Lead for the Medicare Supplement Claims Processing team is responsible for overseeing day-to-day operations to ... daily direction and oversight to a team of claims processors handling Medicare Supplement claims. * Monitor team productivity, quality, and turnaround time; identify… more
- TEKsystems (Dallas, TX)
- …role will conduct collections activities which will entail contacting Medicare Administrative Contractors (MACs) to reconcile outstanding accounts receivable (debit ... resolve all unpaid or underpaid system debit balances on Medicare insurance claims; Actions include but are not limited...include but are not limited to remit and EOB review , calling payer(s) and clinics, rebilling claims, navigating payer… more