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The incumbent reviews and analyzes key program, regulatory and operational performance indicators for the functional areas reporting to the Assistant Director, Medicare Advantage Operations and makes recommendations to the leadership team on strategies to improve performance.
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Using discretion and independent judgment, the Patient Assessment Coordinator coordinates the process of providing accurate and timely data to the appropriate entities involved in the Prospective Payment System and quality reporting program for Medicare patients.
Full-timeExpandApply NowActive JobUpdated 24 days ago - UpvoteDownvoteShare Job
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Handles Medicare billing and coding issues directly related to Medicare rules and regulations and HSCRC requirements. Prepares required HIPAA breach reporting for reporting submission and enters into current government reporting system as required after review by Compliance Director.
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Develops Compliance Hotline statistical data for reporting to the Audit and Compliance Committee of the Board of Directors, the Executive Compliance Committee, the Affiliate Compliance Officer Committees and other meetings as requested.
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Follows all MCO, Medicare, Medicaid, and HIPAA regulations and requirements. Position Summary : The Senior Accountant will take ownership of financial reporting for an operating region within the company and be responsible for month end close, balance sheet reconciliations and special projects.
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Demonstrates basic knowledge of regulatory or Third Party Payer insurance requirements including Medicare, AHCCCS/Medicaid, Workers Comp and other commercial payers. Responsible for reporting any safety-related incident in a timely fashion through the Midas/RDE tool; attends all safety-related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.
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Maintain data collection, recording, and reporting systems to ensure proper service, uniform accounting, data collection, and measurement of outcomes. Follow all Medicare, Medicaid, and HIPAA regulations and requirements.
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Medicare, Medicaid (ACO / MCO) and other government programs. 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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Reporting into the Medical Value Liaison Field Director, the Senior Medical Value Liaison (MVL)/Executive MVL is a field-based role focused on applying clinical expertise and experience/knowledge of payors, health policy, payer utilization management, and pharmacoeconomics to strategically support Karuna’s scientific strategy and business objectives.
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Subject matter expertise in healthcare claims data preferred, and even better with experience in HEDIS, quality reporting, clinical (EMR/EHR; Epic) or enrollment/membership data; experience with Medicare and Medicaid data is a plus.
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The Sr Financial Analyst maintains current knowledge of the Medicare Cost Report regulations related to SOT and uses that knowledge to ensure all data vital is present to assure accurate MCR reporting.
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Job Responsibilities:Reviews medical record documentation and accurately assigns appropriate ICD-10 diagnoses and procedure codes, leading to the assignment of the correct Medicare Severity-Diagnosis Related Group, (MS-DRG) or All Patient Refined Diagnosis Related Group, (APR-DRG.) The Inpatient Coding Specialist is responsible for verification of the patient's discharge disposition and to ensure the appropriate present on admission, (POA) indicators are assigned to each code.
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Perform LPN and Home Health Aide supervisory visits, in accordance with state regulations, to evaluate competency and provide appropriate instructions. Must have reliable transportation, current driver's license and appropriate automobile insurance; or ability to take public transportation.
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Proficient in compiling data, creating reports, and presenting information, using Crystal Reports (or similar reporting tools), SQL query, MS Access, and MS Excel. Responsible for the strategic development and administration of contracts with State and/or Federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations.
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The Segment Marketing Senior Manager will oversee direct-to-consumer (DTC) marketing for the Cigna Medicare Part D (PDP) business, reporting to the VP of Marketing. DTC Marketing Senior Manager - Medicare - Hybrid.
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