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Applies the Centers for Medicare & Medicaid National Coverage Determination (NCD) 310.1, Routine Costs in Clinical Trials, to determine if the study is a qualifying clinical trial with therapeutic intent, diagnosed disease, Medicare benefit category, and deemed status or seven desirable characteristics.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Key Responsibilities Utilize knowledge & skills set to accurately complete Medicare, Medi-Cal, Tricare, Champ VA, Medicaid Programs & other non-specific governmental & commercial (BCBS, Aetna, UHC, etc.
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Review the Medicare, Managed Care, Medicare Advantage and Medicaid UB, CHAMPS, WebDenis. Process Medicaid applications. Ciena Healthcare is Michigans largest provider of skilled nursing and rehabilitation care services.
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Assist in the preparation of the Medicare & Medicaid cost reports for all McLeod entities including hospitals, home office, rural health clinics, home health, hospice and other facilities as required.
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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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This role is likely to be focused on either Medicaid Managed care data used for compliance and oversight, or on the Medicare Quality Review Program. Preferred: Knowledge of Medicaid payments and claims.
Full-timeRemoteExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Serves as a subject matter expert for clinical documentation integrity (CDI), Case Mix Index (CMI) and multiple reimbursement systems (i.e., APR-DRG, Medicare, Medicaid, etc.) Assist with reviews of all Medicare and Medicaid audits including but not limited to RAC, THHS.
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Also included under the oversight of the CFO is Revenue Cycle Management, Patient Experience, Accounts Payable management, Budget & Forecasting, Payroll, Cash Management, General Ledger, Account Reconciliation, Population Health and Grants Management, Health Resource and Services Administration (HRSA) grant reporting as related to the Electronic Handbook (EHB) and Uniform Data Systems (UDS), Medicare and Medicaid Cost Report activities.
Full-timeExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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Monitor accuracy and timeliness of Electronic Data Processing Systems (EDPS) and Medicaid encounter data submissions to ensure compliance with Centers for Medicaid and Medicare Services (CMS) and Oregon Health Authority (OHA) regulations.
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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 5 days ago - UpvoteDownvoteShare Job
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Provides Medicare, Medicaid (case mix), and managed care oversight to ensure appropriate clinical services are provided and appropriate reimbursement is received for each resident. Three Rivers Healthcare Center and Brookside Healthcare Center, members of the CommuniCare Family of Companies, are currently recruiting an RN MDS Nurse / Resident Assessment Coordinator (RAC) to join our team.
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The Centers for Medicare and Medicaid Services (CMS) rated Stamford Hospital as a five-star hospital for Overall Quality and The Leapfrog Group awarded Stamford Hospital an “A” for patient safety.
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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. Understanding of Medicaid, Medicare and Dual-Eligible programs and populations.
ExpandApply NowActive JobUpdated 11 days ago - UpvoteDownvoteShare Job
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Many of our skilled nursing facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Princeton Transitional Care & Assisted Living is a partnership between Signature HealthCARE and Ballad Health bringing a new level of health care services to the Tri-Cities area.
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Mount Vernon Healthcare Center, a member of the CommuniCare Family of Companies, is currently recruiting an RN MDS Nurse / Resident Assessment Coordinator (RAC) to join our team. QUALIFICATIONS & EXPERIENCE REQUIREMENTS Graduate of an accredited school of nursing; RN Valid RN license in the state employed Three years of experience in a long term care environment preferred Experience with the MDS/RAI process and/or case management preferred JOB RESPONSIBILITIES The MDS Nurse RAC (Resident Assessment Coordinator) reports to the Executive Director and is responsible for accurate and timely completion of mds assessments and coordination of the RAI process.
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