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The CRS manages the overall resident assessment process and tracking of all Medicare/Managed Care/Medicaid case mix documents in order to ensure appropriate and optimal reimbursement for services provided within the Care Center.
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Clinical Care Coordinator reports to the Director of Nursing and/or the Facility Administrator. Utilization review, including Medicare management, documentation requirements. Reviews infection control issues with infection control nurse, and coordinates integration of policies.
$50 - $55 an hourExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Experience working in Medicare Advantage Global Risk Models. We are seeking a Physician to join our team as the Market Medical Director, with a focus on providing exceptional care to our senior patient population.
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Monitor documentation audits, Medicare compliance and patients approaching MMR cap. The Physical Therapist Clinical Director is responsible for complete oversight of operations and administration of rehabilitative outpatient clinic providing Physical and Occupational Therapy.
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Operationalizes and assures compliance with Center for Medicare & Medicaid Services (CMS), Occupational safety and Health Administration (OSHA), Center for Disease Control and Prevention (CDC) and Patient Safety regulations at the service line level.
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JOB SUMMARYUnder the direction of the Director of Licensing and Regulatory Services, provides legal support to in-house counsel, home health, hospice, home care, and senior living operations as part of a dynamic in-house legal department.
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These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company.
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Provides timely feedback to the Manager or Director of any posting problems. Assists in other duties as assigned by Manager or Director. Cash Posting Specialist will process private pay, Medicare and Medicaid electronic payments, assist with working the Exception Report, balance cash and the general ledger cash clearing account.
Full-timeExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
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Actively participate in responding to audits and denials from third party insurance and intermediaries (i.e. Medicare) The medical director has overall responsibility for medical direction of the care and treatment of patients and their families rendered by the hospice care team, and shall consult and cooperate with the patient's attending physician.
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Knowledge of current Medicare Advantage operational and regulatory guidelines established by CMS, AHCA and other federal and state regulatory guidelines. Performs other job related duties as assigned from time to time by the VP Network Development and/or President/CEO.
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Working knowledge of nursing home regulations and the Nurse Practice Act, including MDS procedures and reimbursement guidelines under Medicare and Medicaid and standards of practice relating to the prevention of weight loss, pressure wounds, unnecessary pain, and falls.
$110,000 - $120,000ExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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The RN Director of Clinical Documentation Reimbursement (CDR) is responsible for the overall operational and strategic planning of the Clinical Documentation and Reimbursement (CDR) Department and Health Information Management (HIM) Department.
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Performs job related functions including, but not limited to, facility based scheduling, bed planning, pre-registration, registration, insurance verification, pre-certification, point of service cash collection and financial clearance under the direction of the Supervisor/Manager/Director for these designated areas.
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This role reports to the Regional Director of Operations or Regional Vice President (depending on location) and has an opportunity for advancement. Partner with the Center Medical Director and Outreach Manager to lead the center as a triad and make collaborative decisions that support the best interests of the patients and team and drive profitability for the center.
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