...Experience in utilization management or related activities reviewing criteria to ensure appropriateness of care preferred
Previous Medicare experience a plus
Milliman MCG experience preferred
Additional Information
Hours: 8am-5pm EST
Work-At-Home Requirements:
To ensure...
Suggested
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Weekly pay
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Full time
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Apprenticeship
Home office
...profit healthcare systems and organizations, to include DoD Tri-Service Military Healthcare Systems, TRICARE purchased care system, Medicare, Medicaid and the Veterans Administration (VA) Preferred
Physical Demands (The physical demands described here are...
Suggested
...responsible to ensure accounts are billed accurately due to regulatory requirements, such as combining for outpatient overlap or Medicare three day payment window, as well as to, reconcile accounts and provide QA across the various patient accounting systems for the hospitals...
Suggested
...codes for the billing process and the statistical database. This position is also responsible for routinely tracking the incomplete Medicare records awaiting DRG prompter responses. Responsible for daily maintenance of the unbilled accounts report. Works in conjunction...
Suggested
...experience supporting provider management (This is critical for this position.)
~5 years of experience in MMIS or domain knowledge of Medicare, Medicaid, or with a major healthcare payer
~2 years of experience with multi-vendor project
~ Expert/Advanced experience in...
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...information
* Maintains regular, predictable, consistent attendance and is flexible to meet the needs of the department
* Follows all Medicare, Medicaid, and HIPAA regulations and requirements
* Abides by all regulations, policies, procedures and standards
* Performs...
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Local area
Flexible hours
...codes for the billing process and the statistical database. This position is also responsible for routinely tracking the incomplete Medicare records awaiting DRG prompter responses. Responsible for daily maintenance of the unbilled accounts report. Works in conjunction...
Suggested
...Job Description The Billing Coordinator manages Carastar's billing and revenue cycle and the processing of payments from Medicaid, Medicare, and Commercial payers. Also, the coordinator will lead and supervise a team of billing specialists.
SUPERVISORY...
Suggested
...$ 50
Spouse $ 50
The wellness premium applies only to the Blue Cross Blue Shield Hospital Medical Group #14000 plan for non-Medicare eligible active and retired members, non-Medicare-eligible members on LOA or COBRA, and non-Medicare-eligible spouses on active or...
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Afternoon shift
...appealed and resolved timely.
Advanced knowledge of CPT, ICD-10 coding and billing, UB and 1500 billing.
Advanced knowledge of Medicare, Medicaid and third party payment methodologies.
Advanced knowledge of CMS Medicare regulations.
Advanced knowledge of...
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Permanent employment
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...Thorough knowledge of physician billing, collecting, and reimbursement industry standards
Knowledge of the regulations related to Medicare and Medicaid, patient rights, compliance, and other related areas
Knowledge of professional business and communication...
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...Relations Manager
Role Description
The purpose of the Patient Relations Manager at Oak Street Health is to educate patients about Medicare programs, resources, and affordable insurance coverage options available to them in order to increase patient access to care and...
Suggested
Flexible hours
...to identify and address issues before they become major problems.
Knowledge of relevant regulations and guidelines, including Medicare and Medicaid regulations.
Ability to work effectively in a fast-paced environment, with the ability to manage multiple priorities...
Suggested
...Community Relationship Managers (CRMs) are an integral part of our broader Outreach team, which is responsible for engaging adults on Medicare in the community to help drive new patient growth. Building relationships with community leaders to create opportunities for the...
Suggested
Work experience placement
Local area
Flexible hours
...s financial responsibility at the point of service, and satisfaction of regulatory requirements, medical necessity determination, Medicare Secondary Payer completion and coordination of benefits, Important Message from Medicare issuance and signage, HIPAA, and EMTALA....
Suggested
...certified (ABMS or AOA) in Family Medicine, Internal Medicine or Geriatric Medicine preferred
Active and unrestricted DEA license
Medicare Provider Number
Medicaid Provider Number
Demonstrate a high level of skill with interpersonal relationships and...
Holiday work
Temporary work
$60 - $180 per hour
...availability. And to streamline administrative tasks, we handle everything from NPI/CAQH Application to Insurance Enrollment and Medicare/Medicaid Enrollment, allowing counselors to focus solely on counseling.
Your Role:
Independence meets empathy, experience...
Hourly pay
Freelance
Remote job
Work from home
Flexible hours
...The purpose of a Primary Care Physician at Oak Street Health is to provide equitable and effective value-based healthcare to local medicare patient populations at our innovative network of neighborhood primary care centers. Our Primary Care Physicians operate at a...
Holiday work
Full time
Local area
Immediate start
Relocation package
Flexible hours
Monday to Friday
...Oak Street Health is on a mission to 'Rebuild healthcare as it should be'', providing personalized primary care for older adults on Medicare, with the goal of keeping patients healthy and living life to the fullest. Our innovative care model is centered right in our...
Flexible hours
...scale.
+ Hands-on experience and familiarity with complex care management and programs in valued-based care, senior care, and/or Medicare.
**Knowledge/Skills/Abilities/Competencies Required**
+ Expertise in understanding of population health and full-risk...
Holiday work
Full time
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Apprenticeship
Local area
Flexible hours
...delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the...
Holiday work
Full time
Temporary work
...following credentials: LCSW, LMSW, MD, DO, NP/PMHNP, etc.
~ Proficiency with using Symplr Credentialing Database preferred
~ Medicare & Surrogacy Experience Required
~ Experience working with online payers - delegated & non-delegated accounts
~ Familiar with credentialing...
Remote job
Holiday work
Full time
Temporary work
Local area
Immediate start
Monday to Friday
...Oak Street Health is on a mission to 'Rebuild healthcare as it should be'', providing personalized primary care for older adults on Medicare, with the goal of keeping patients healthy and living life to the fullest. Our innovative care model is centered right in our...
Full time
Relocation bonus
Flexible hours
Day shift
...'s financial responsibility at the point of service, and satisfaction of regulatory rquirements (medical necessity determination, Medicare Secondary Payer completion and coordination of benefits, important message from Medicare issuance and signage, HIPAA, and EMTALA)....
Full time
Part time
Relief
...approved survey protocols for conducting on-site surveys.
Specific activities include the following:
Conduct on-site surveys of Medicare-Medicaid certified health care facilities to determine compliance with Federal regulations.
Surveys require preparations such...
Holiday work
Full time
Immediate start
Remote job
Flexible hours
Monday to Friday
...patients, maintaining accurate records, following recommendations from physicians and clinical supervisors. The ideal candidate will also be knowledgeable in Medicare, Medicaid, and private insurance, as well as the ability to complete relevant insurance documentations.
...company and individual performance.
Staff in our Health unit will eventually work with our largest client, Centers for Medicaid & Medicare Services (CMS). Most staff working on CMS contracts will be required to complete a successful background investigation including...
Remote job
Local area
Work from home
...discharge planning seeks assistance from the physician advisor if needed and informs management of the possible need for issuing Medicare Hospital Initiated Notice of Noncoverage.
~ Applies approved utilization criteria to monitor appropriateness of admissions level...
Full time
Temporary work
For contractors
Work experience placement
Relief
Local area
...clients by acting as their independent advisor and broker for products in life insurance, health insurance, retirement, annuities, medicare, senior benefits and more. Planright is remaking the industry for agents by agents. Each agent owns their book of business. We...
...by the ANCC or AANP
Active/unrestricted Maryland NP license (new graduates will be considered)
Ability to be credentialed by Medicare, Medicaid, and other private insurance companies
Proficiency with various computer-based applications (MS Office, logging into...
Contract work
Part time
Immediate start
2 days per week
3 days per week