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Good working knowledge of healthcare billing, Medicare/Medicaid billing guidelines, and other Third Party Payor rules and Regulations. The following certifications are acceptable-RHIT/RHIA/AAPC, CPC, or CPMA.
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Working knowledge of Medicare compliance, OSHA, and HIPAA. Comprehensive understanding of fee schedules, payor policies and managed care contracts, including Medicare and Medicaid. Strong working knowledge of ICD-10, CPT, HCPCS, referrals and pre-certification procedures, as well as documentation guidelines.
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In-depth knowledge of Medicare billing guidelines and industry best practices. In-depth knowledge of Medicare billing guidelines and industry best practices. Strong understanding of ICD-10, CPT, HCPC, and Modifier codes.
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Knowledgeable in Healthcare regulatory laws and frameworks: CMS (Medicare, Medicaid), HIPAA, NIST and HITRUST. Experience with control frameworks including related regulatory compliance requirements (e.g., SOC, SOX, HITRUST, HIPAA, FedRAMP, PCI) required.
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This position is responsible for working Medicare, Medicaid and Managed Care claims after initial submission. Previous experience with Medicare/Medicaid electronic billing required. Follow Medicare guidelines when editing and submitting electronic claims.
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Knowledge of third party reimbursement, including Medicare, Medicaid and commercial insurance required. The OHH Patient Account Specialist- BILLER position insures patient claims are produced, processed and submitted for payment accurately and timely.
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Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management.
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Diversity and Inclusion: PacificSource values the diversity of the people we hire and serve.
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Instruct patient and family members on proper use of equipment such as wheelchairs, braces, walkers, crutches, canes, and other prosthetic/orthotic devicesCompletes all clinical documentation following agency protocol and Medicare/Federal guidelines.
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Answer questions about Medicare and Medicaid. Knowledgeable about Medicare and Medicaid. We're looking for a Remote Customer Service Representative , working in Healthcare Systems and Services industry in Nashville, Tennessee, United States.
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Manipulates and extracts Medicare, Medicaid, and other healthcare claims data stored in Cloud environment using appropriate software such as SAS, Snowflake, Python, R, SQL, and other software as appropriate for the task.
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This leader will collaborate closely with the MarketPoint RVPs of the West and Florida regions, local market leadership, local and national partner leadership, Sales Integrity, Product and Marketing Leadership, Medicare Sales Strategy team and Corporate Strategy.
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Knowledge of accepted professional standards and practice, Medicare Conditions of Participation, and federal, state, and local regulatory requirements. Previous experience in home care setting with two years management or supervisory experience, preferred.
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The QA Test Lead will be responsible for overseeing and managing the end-to-end testing of one or more modules in a mult million-dollar Medicaid Enterprise System (MES)/Medicaid Modular Information System (MIMS) project for the State of North Carolina.
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Must meet Center for Medicaid/Medicare Services (CMS)-approved national certification requirements within the CMS timeline. Liberty Administrative Services, LLC treats all individuals equally without regard to race, color, religion, sex (gender identity, gender expression, transgender), sexual orientation, age, pregnancy, parenthood, marital status, national origin or ancestry, citizenship status, disability, military status, genetic predisposition or carrier status or any other impermissible factor according to applicable law.
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