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Screen clients using PointCare for eligibility in and assist with enrollment/re-enrollment in Covered CA, Medi-Cal, Medicare, MHLA, commercial products, Ryan White, ADAP, PrEP-AP as well as with the process of accessing Public Benefits.
$23.92 - $28.45 an hourFull-timeExpandApply NowActive JobUpdated 30 days ago - UpvoteDownvoteShare Job
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Compliance oversight for "Schedule A" request from carriers, Form 5500, Medicare Part D Disclosures and CMS Reporting, HIPAA and ERISA and COBRA. Assist bSwift team with completion of the bSwift requirements document for any assigned clients that are engaging bSwift as their ben admin and online enrollment technology.
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Review 1st bill following renewal for each line of coverage to ensure sold rates/enrollment counts are accurate. Enrollment Meetings - Coordinate meeting agenda and times with Client and Carriers and conduct meetings as necessary.
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MetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
$50,000 a yearFull-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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Coordinates the arrangements for the Medicare Part D enrollment each fall. Meets with SHIIP chair to determine scheduling, supplies, publicity, and extra volunteers that assist with Medicare enrollments.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Understanding of Self-funding, Stoploss, Pharmacy Benefit Management, ERISA guidelines, Affordable Care Act, Section 125, HIPAA and PHI. Oversees annual reporting and filings, ensures accuracy of data and meets appropriate deadlines for 5500 / SAR, Creditable Coverage and Medicare Part D CMS disclosures, CMS demand letters, Healthcare Exchange Appeals, Covered California Appeals, 1095-C, PCORI, Form 720 and Non-Discrimination Testing.
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Manage the annual Medicare/D-SNP plan benefit package design and bid filing with CMS, ensuring accuracy and timeliness of submissions as well as desk review inquiries. Serve as an internal subject matter expert (SME) and ensure readiness of D-SNP operational functions and performance (e.g., Marketing, Sales, Enrollment, Risk Adjustment, STARs.
$120,686 - $156,735.06 a yearFull-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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Some tools may include but are not limited to Authorization Guidelines, Insurance Guidelines, Fee Schedules, NPI (National Provider Identifier), PECOS (the Medicare Provider Enrollment, Chain, and Ownership System) and "How-To" documents.
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This role also requires knowledge of health plan operations including Medicare and Medicaid plans, claims processing, EDI transaction processing, enrollment, financial reconciliation, and IT systems knowledge.
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Eligible for enrollment as a Medicare and Medicaid provider in state of practice. Walmart Health employs on-the-ground health providers to be a first-of-its-kind health center to deliver primary and urgent care, labs, x-ray and diagnostics, counseling, dental, and hearing services all in one facility.
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Master’s degree from a physician assistant educational program accredited by the Accreditation Review Committee on Education for the Physician Assistant (ARC-PA) 2 years’ experience as a physician assistant in a primary and/or urgent care setting.
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Our contingent workforce plays a critical role in working with our new and existing Medicare member clients to process enrollments and various other requests. The position will work in accordance with the Center for Medicare/Medicaid Services (CMS) guidelines to ensure regulatory compliance takes place.
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Familiarity with Chapter 2 - Medicare Advantage Enrollment and Disenrollment guidance. MA Enrollment Operation. Familiarity with Chapter 2 - Medicare Advantage Enrollment and Disenrollment guidance.
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Partner with COL, credentialing coordinators and other key stake holders in onboarding and enrollment providers and facilities with Medicaid, Medicare, commercial and managed care plans.
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Responsible for Medicare and Medicaid enrollment for ambulatory surgery centers as well as Railroad Medicare and Tricare. Responsible for reporting surgery center changes to State and Federal licensing agencies, Medicare, Medicaid and accreditation agencies.
Full-timeExpandApply NowActive JobUpdated 2 days ago
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