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Basic knowledge of eligibility criteria for managed care programs such as those funded by Medicare, Medicaid and Commercial Insurance Plans. Partnering with the LSU School of Medicine, our goal is to provide high-quality patient care within a setting that advances medical science through research and educates the next generation of leaders in healthcare.
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Background with Medi-Cal, Medicare, managed care, and PPO insurance. Knowledge of EPIC is a plus UCLA Health is a world-renowned health system with four award-winning hospitals and dozens of primary care practices, specialty practices, urgent care centers and other ancillary locations throughout metro Los Angeles as well as the David Geffen School of Medicine.
$26.85 - $35.41 an hourFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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O Strong background and familiarity with Medicare, Medicaid, I-SNP, nursing facility and managed care desired. This role requires excellent management skills backed by a strong understanding of Medicare, Medicaid and managed care regulations.
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Two to five years previous experience in financial counselling, and health care financial clearance is preferred for knowledge of common insurance plans and limitation, knowledge of Medicare and Medicaid plans and rules.
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At least 4+ years of experience in a managed care environment (will consider other relevant health care, social service, insurance or not-for-profit experience) Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region.
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Effectively communicate and appropriately collaborate with the Market Access team to ensure strategic alignment and effective implementation of the clinical strategy for National and Regional Managed Care accounts, covering all books of business (e.g., Commercial, Managed Medicaid, Fee-for-Service, Medicare, PBMs, and Exchange Plans.
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Background in ICD9 and CPT coding and all insurance plan types (HMO, PPO, Managed Care, Medicare, Medicaid, and commercial insurances). UT Health East Texas Physicians has over 90 primary and specialty care clinics, providing comprehensive medical education and innovative research.
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Coordinate the process of completing state-required assessments that determine payments from Medicare, Medicaid, and Managed Care by performing ongoing compliance related to Skilled Nursing Services.
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Accounts Receivable – Private, Private Co-Ins, Managed Care Co-Ins. Accounts Receivable – Medicare. Must have 5 years experience in Long-term Care business office. Regent Care Centers is committed to being an equal opportunity employer and will not discriminate on the basis of race, color, religion, gender, disability, age or national origin or any other protected status.
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Review the Medicare, Managed Care, Medicare Advantage and Medicaid UB, CHAMPS, WebDenis. Minimum 3 years experience in A/R capacity in the long term care setting is preferred.
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Strong background and familiarity with Medicare, Medicaid, ISNP, Nursing Facility and Managed Care preferred. The Program Manager is responsible for conducting clinical audits of the providers to ensure excellent service deliver, and that care is administered in accordance with Medicare, Medicare Advantage, and all other compliance programs, state laws and regulatory compliance, privacy and security, detecting, preventing, and correcting fraud, waste, and abuse.
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Collaborates with Finance staff and Managed Care Contracting staff to ensure accurate billing of accounts under global contracts/Center of Excellence agreements. The Senior Financial Analyst will serve as the Solid Organ Transplant primary internal consultant responsible for providing critical analytical support for regulatory and financial implications of the Transplant components of the Medicare Cost Report (MCR.
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General knowledge of medical insurance providers including HMO’s, PPO’s, Medicare, managed care insurance companies, and Medi-Cal to determine co-payments. Interpersonal skill sufficient to interact diplomatically with the public in a high volume public contact setting and with members of the health care team.
$24.57 - $34.87 an hourFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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You are: Experienced in healthcare, provider engagement, Medicare, Commercial and Medi-Cal managed care systemsRelentlessly resourceful. The Provider Relations Manager will be working with contracted providers on managed care operations and to comply with IPA and Health Plan standards.
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Acts as an advisor and consultant in the establishment of operational policies of the practice to include: (1) Purchasing and capital allocations; (2) Managed care plan participation; (3) Budget and practice expenses; (4) Medicare/Medicaid participation; (5) Billing and collection of professional fees; (6) Personnel management and related policies; (7) Risk management and quality assurance; and (8) Coding compliance.
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medicare managed care jobs
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