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The Clinical Data Steward is a member of a cross-functional Data Governance team who partners with business, technical, and regulatory partners to ensure the documentation and implementation of Medicare & Medicaid data standards.
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The Intake Specialist is responsible for completing the behavioral health intake process as prescribed by Medicaid and WAC for each child assigned which includes: completing a diagnostic formulation using clinical and diagnostic assessment tools, gathering child and family medical and behavioral health information, completing complex behavioral health intake documentation and determining initial treatment areas for intensive behavioral health services.
$36.51 an hourExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. As a Clinical Documentation Improvement (CDI) Liaison, you will be responsible for the interface between facility based Clinical Documentation Improvement Specialists and the coding staff.
Full-timeExpandApply NowActive JobUpdated 22 days ago - UpvoteDownvoteShare Job
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Support chart audit processes, including audit provider and vendor documentation of ICD-9 and ICD-10 codes to ensure adherence with Center for Medicare Services (CMS) risk adjustment guidelines, and act as a liaison between internal departments and external entities on regulatory data validation audits (including CMS RADV and HHS RADV.
$65,490 - $100,200 a yearFull-timeExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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Review clinical documentation and submit to insurance companies for initiation and obtaining authorization or pre-certification on OP diagnostic hospital services. In conjunction with the Medicaid Eligibility Staff visit all uninsured patients in-house.
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This position ensures that the documentation supports the levels or types of service billed, ensures the documentation is in compliance with Medicare/Medicaid billing regulations, and provider documentation guidelines, CPT documentation and CMS coding guidelines.
$30.27 - $40.92 an hourPart-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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Manage, coordinate, and write/update APDs and associated documentation required for planning, implementation, and operations activities according to U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services (HHS CMS) and U.S. Department of Agriculture Food and Nutrition Service (USDA FNS) guidelines, including but not limited to APDUs, Monthly Status Reports, CMS Outcomes, and State Specific Goals.
Full-timeRemoteExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Experience with Current Procedural Terminology (CPT)/ Healthcare Common Procedure Coding System (HCPCS) Coding methodology and hospital/physician billing systems such as IDX, SMS or EPIC. Knowledge of Medicaid, Medicare and HMSA coding and billing rules.
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Equivalent Experience: As required by Medicare and Medicaid Services (CMS) to be employed through MidMichigan Health all Medical Assistants must possess one of the following active certification/licensure:Registered Medical Assistant (RMA) through American Medical Technologist (AMT)Certified Medical Assistant (CMA) through American Association of Medical Assistants (AAMA)OR equivalent Medical Assistant Credential such as (Certified Clinical Medical Assistant CCMA, etc.
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Provide the appropriate documentation for service delivery including treatment goals, progress notes and billing and submit said documentation as specified by Medicaid, Medicare and CARF standards.
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Experience with electronic health records (EHRs), Medicaid billing, ePACES, Medicaid Analytical Patient Portal (MAPP), Universal Assessment System (UAS) Identify and provide insight into trends found in charts and documentation to provide staff with the necessary tools, trainings and guidance to ensure quality care coordination.
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The Business Office Manager is the primary individual responsible for the timely collection of private pay accounts receivable and working with residents/families on obtaining Medicaid eligibility, if applicable.
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Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan.
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Adjudicate all claims types including Dental, Vision and Medical claims for inpatient and outpatient facilities, physician claims, In and Out of Network claims, Medicaid reclamation (HIPD), outpatient lab and radiology, accident and Third-Party Liability (TPL) claims, by calculating benefit due to approve or deny, based on SPD and within accepted corporate cycle timeframe.
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Demonstrated knowledge of NYS Medicaid & Medicare Programs, MDS based Case Mix Reimbursement systems; and documentation requirements. Completes documentation related to clinical information and other related items, as assigned.
$59,762 - $88,533 a yearFull-timeExpandApply NowActive JobUpdated Today
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