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Maintain continuous communication with the resident, responsible party, outside attorney, facility attorney or outside provider if the application was completed with someone other than the Medicaid Coordinator, in conjunction with the Business Office Manager.
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Investigate and process Medicaid Conversions, Recertification’s, Applications, Provider Changes, and monthly Roster’s for all counties. We are currently seeking a full time Medicaid Coordinator who will embody the passion and commitment required to deliver the ultimate care for our residents.
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Advanced in Medicare/Medicaid regulations, health care terminology, and various software packages and applications such as Medicare Cost Report software (HFS Software) Proficient in Medicare/Medicaid regulations, health care terminology, and various software packages and applications such as Medicare Cost Report software (HFS Software.
RemoteExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Contractual arrangements include but are not limited to Medicaid, Commercial, Medicare Advantage, Medicare Accountable Care Organization (ACO) Reach, ACO – Medicaid, Capitation and global shared savings/risk.
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The Provider Enrollment Specialist provides support and completion of provider enrollment applications for governmental and non-governmental payers for MPOWERHealth/Acquisition Billing clients.
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Minimum of one year paralegal/legal assistant experience, preferably in healthcare environment or experience in Medicare or Medicaid provider enrollment or private payer enrollment/credentialing.
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Cityblock is the preeminent value-based care provider focused primarily on high needs populations, specifically Medicaid and Dual-Eligible beneficiaries. Cityblock’s VP of Finance must be an experienced finance executive, ideally with expertise in Medicaid, Medicare Advantage / Duals (e.g., D-SNP, MMP) programs, and/or value-based care.
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Responsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD-10 codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures.
$18.5 - $35.29 an hourFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Provider Enrollment Specialist (PESC) certificate. Applies advanced knowledge of regulatory and accreditation standards such as The Joint Commission (TJC), National Committee for Quality Assurance (NCQA), Centers for Medicare & Medicaid Services (CMS), Health Resources and Services Administration (HRSA) to ensure continued compliance in all matters pertaining to professional staff services.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Certified Provider Credentialing Specialist (CPCS) certification - PreferredExperience working within a health plan, managed care organization, provider operated healthcare environment or Third-Party Administrator (TPA)/Business Process Outsourcing (BPO) - RequiredExtensive knowledge of computers and related software applications, such as Word, PowerPoint, Excel, Project - RequiredPrior supervisory or management experience – Required.
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Experience working in healthcare provider analytics related to revenue modeling, managed care contracting, population management, case management, clinical or financial decision support required.
$86,000 - $165,000 a yearFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County.
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Ciena Healthcare is Michigans largest provider of skilled nursing and rehabilitation care services. Review the Medicare, Managed Care, Medicare Advantage and Medicaid UB, CHAMPS, WebDenis.
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Sets up and verifies active and contracted insurance coverage in multiple systems and/or educates patients on co-insurances/co-pays, self-pay, L&I, MVA, Medicaid, Medicare/Medicare Advantage, etc.
$20.57 - $32.92 an hourPart-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Researches and resolves assigned Medicaid Provider Enrollment and Site Visit related issues and documents their findings to Program Administrator and Program Operations Administrator. This position is responsible for planning and conducting in-house and on-site New Provider Enrollment Reviews and validating re-enrollment reviews of current Medicaid providers to determine if they meet Medicaid provider enrollment requirements.
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