- R1 RCM (Boise, ID)
- …bad debts. The team works with a large variety of hospitals and systems to review and test Medicare bad debt claims for Medicare reimbursement. ... transform and solve challenges across health systems, hospitals and physician practices. Our mission is to be the one...operating costs and enhancing the patient experience. As our ** Medicare Bad Debt Analyst** you will work with the… more
- RWJBarnabas Health (Oceanport, NJ)
- Inpatient Coding Quality Officer III - ( Medicare )Req #:0000183242 Category:Coder Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services ... integrity of ICD-10-CM/PCS coding and DRG assignment for inpatient Medicare encounters. This requires critical thinking and a higher...a team with other Quality Officers to ensure SMART review goals are met for all RWJBarnabas facilities. +… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …fully remote with the ocassional time onsite as needed.** The Sr. Medicare Coverage Analyst (MCA) is responsible for reviewing clinical research protocols, Informed ... insurance and which should be billed to the study sponsor. The Medicare Coverage Analyst determines whether proposed clinical research studies are a Qualifying… more
- UCLA Health (Los Angeles, CA)
- Description As the Program Manager of Medicare Advantage Marketing, you will provide tactical support for implementing innovative marketing strategies and plans for ... New Century Health Plan's Medicare Advantage Growth Office. This position will play a...vendors to create effective marketing solutions. + Oversee the review and approval process for all prospect, member, and… more
- Molina Healthcare (Dayton, OH)
- …medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews quality referred ... requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial process. + Monitors appropriate care and services… more
- Fallon Health (Worcester, MA)
- …integrated care for our members with a special focus on those who qualify for Medicare and Medicaid. We also serve as a provider of care through our Program of ... network, thereby reducing their dependence on the medical system. * Offers proactive review of members for a multidisciplinary care planning with PCPs and Care Teams… more
- Centene Corporation (Jefferson City, MO)
- …cost containment, and medical quality improvement activities. + Performs medical review activities pertaining to utilization review , quality assurance, and ... + Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership. + Conduct regular… more
- Catholic Health Initiatives (Omaha, NE)
- …denial management, compliance with governmental and private payer regulations, appropriate physician coding and documentation requirements.** + Review medical ... Message from Medicare (HINN). Discuss the case with the attending physician and if additional clinical information is not available, coordinate the process with… more
- Ochsner Health (New Orleans, LA)
- …Board Certification by the American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) or (3) Physician Advisor Sub-Specialty Certification ... make a difference at Ochsner Health and discover your future today!** The Physician Advisor (PA-Utilization Management) serves as the physician leader in matters… more
- CenterWell (Tallahassee, FL)
- …as a collaborating physician for several nurse practitioners or physician assistants, including completing regular chart review , coordinating monthly ... We are excited to offer the role of Virtual Physician for a new virtual care delivery group within...* Meet with medical leader about quality of care, review of outcome data, policy, procedure, and records issues.… more
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