Average salary: $64,658 /yearly
More statsSearch Results: 31 vacancies
...insurance guidelines.
•Strict adherence to eligibility and enrollment criteria governed by the Centers for Medicare & Medicaid Services (CMS) Medicare Managed Care Manual. Ensuring that all premiums are accounted for and reconciled for new and existing members/group against...
Cms
...HPMS), Smartsheet, Sharepoint, Microsoft Office (Word, Excel, PowerPoint), and database software.
Knowledge of Medicare programs and CMS regulations and the ability to provide operational guidance and support for defining and documenting data validation policies and...
Cms
Contract work
Work experience placement
Local area
$36.46 - $46.88 per hour
...experience, this is a great opportunity for you
Evaluates the patient's functional status, status of all body systems as required for CMS documentation, and physical therapy needs. Consults with the physician in the development of the therapy plan of care.
Provides...
Cms
Full time
Relocation bonus
...any other protected characteristic.
DaVita is a clinical leader! We have the highest percentage of facilities meeting or exceeding CMS's standards in the government's two key performance programs. We expect our teammates to commit to improving patient health through...
Cms
Holiday work
Flexible hours
Shift work
Weekend work
Day shift
Afternoon shift
...Prominence Medicare Enrollment team. This position will support staff to ensure the enrollment process is in compliance according to CMS rules and regulations, accurate and timely. The Supervisor will develop and/or implement policies and procedures and analyze processes...
Cms
For contractors
Local area
...from a variety of sources, i.e. patients, patient's families, physicians, physician office staff, county and/or governmental agencies, CMS, FMS, etc.
This position ensures reimbursement for services rendered through verification of insurance eligibility/benefits,...
Cms
Flexible hours
...from a variety of sources, i.e. patients, patient's families, physicians, physician office staff, county and/or governmental agencies, CMS, FMS, etc.
This position ensures reimbursement for services rendered through verification of insurance eligibility/benefits,...
Cms
Interim role
...patient treatment, health history, diagnosis, and related information. Assignment of ICD-10-CM and CPT codes must be consistent with CMS' Official Guidelines and any regulatory agency guidelines.
Nature and Scope
Incumbents must be proficient with CPT and ICD-10-CM...
Cms
Apprenticeship
...this position is to correctly assign ICD-10-CM diagnostic/procedure PCS codes on clinical encounters in accordance with regulatory and CMS Official Guidelines for coding and reporting to ensure accurate reimbursement.
Nature and Scope
Incumbent provides intermediate...
Cms
Apprenticeship
...local jurisdiction having authority, stakeholders and key internal and external contributors.
•Must have working knowledge of federal (CMS), state (NAC/FGI), and local (TJC) regulations pertaining to projects that are clinical (and non-clinical, with other regulatory...
Cms
For contractors
Local area
...the Risk Adjustment team.
4. Analyze data flow and data integrity to identify areas for improvement.
5. Understand and advise on CMS risk score methodology, including risk score calculation, hierarchical condition categories (HCCs), financial risk receivable calculations...
Cms
Full time
Work experience placement
Shift work
...release of information function and assisting walk-in customers at the Release of Information location. Releases are made following HIPAA, CMS regulations, federal and state laws and the Renown Health release of information policies.
Nature and Scope
The Release of...
Cms
Immediate start
..., SKILLS & ABILITIES
1. Expert knowledge and specific details of coding conventions and use of coding nomenclature consistent with CMS' Official Guidelines for Coding and Reporting ICD-10-CM coding.
2. Incumbent must have thorough knowledge of Anatomy and Physiology...
Cms
Apprenticeship
Remote job
...Resources. Know Your Rights:
Performs Diagnostic Radiographic Procedures according to department protocols, HFAP/TJC/local regulatory/CMS, State and Federal Regulations. Functions as the first line interface with customers and is successful in the accomplishment of their...
Cms
Full time
Work experience placement
Local area
...Management
~ Product Development
Strategic Product Design
Product Insights and Market Intelligence
~ CMS/Regulatory Programming
SNP Programming
Regulatory Submissions
Specifically, the role includes:
Business...
Cms
Full time
Local area
...the model of care (MOC) meets or exceeds regulatory and accreditation requirements for the Centers for Medicare and Medicaid Services (CMS), state Medicaid offices (as relevant), and NCQA, and leads all efforts associated with the successful operation of a CM program. The...
Cms
Full time
Local area
...statistical data to identify trends as well as potential problems/opportunities for improved service quality.
~ Experience working with CMS contracted vendors and systems, such as Retroactive Processing Contractor (RPC), Wipro, MARx, etc. is preferred.
~ Experience in...
Cms
For contractors
Local area
...+ Healthcare (professional) billing, CPT-4 and ICD-10 codes, government, managed care and third-party billing guidelines, AMA, AAP, CMS and coding policies.
+ Understanding of the revenue cycle and how the various components work together preferred.
Universal Health...
Cms
Remote job
Full time
Local area
Shift work
...researching and providing an accurate and appropriate resolution in accordance with the Centers for Medicare and Medicaid Services (CMS) and the state of Nevada Division of Insurance in accordance with state and federal regulations, company policies and NCQA/HEDIS standards...
Cms
Contract work
Work experience placement
Local area
...as they pertain to the health insurance industry.
~ Experience with STAR ratings, care cap reports and risk scores
~Knowledge of CMS, NCQA, and HEDIS regulations as they pertain to the health insurance industry
~ Proven experience reviewing and analyzing statistical...
Cms
Local area
