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Prepare and produce all Wesley primary billing for Medicare, HMO, VA, MLTC as well as secondary Medicaid claims monthly. Handle all Wesley correspondence from residents, Medicaid, Medicare, Commercial Ins, MLTC and VA in a timely manner.
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Perform DME billing for Medicare, Medicaid, Tricare, and other private insurances. Required - High School diploma or equivalent plus 2 years' experience in Medicare/Medicaid and commercial billing - preferably in Durable Medical Equipment setting.
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Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.
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The WellBe care model is a Physician Led Advanced Practice clinician driven geriatric care (care of older adults) team focused on the care of the frail, poly-chronic, elderly Medicare Advantage patients.
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This key leader position provides strategic leadership, value-based guidance, sets operational direction and performance expectations for both leaders and associates in Humana's sales operational areas including Medicare Advantage, Prescription Drug Plans, Medicare Supplement, Medicaid Managed Care Plans and Individual Major Medical insurance plans.
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Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans. Now hiring Senior Java PL/SQL Developer - Remote Eligible.
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HCC Risk Adjustment Coders will be involved with activities of code abstraction for the following programs; including but not limited to, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, Commercial IVA (Initial Validation Audit), and Medicare RADV (Risk Adjustment Data Validation.
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In partnership with and under the direction of the health plan Medicare Compliance Officer and other team members, this position will help develop and maintain systems and processes that demonstrate the principles of an effective Compliance program and promote compliant and ethical behavior in our Medicare Advantage health plans.
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Health care practice experience providing services to Medicare Advantage and Medicaid patients. Medicare Advantage revenue experience strongly preferred. DescriptionMedical Director Opportunity - Medicare Risk Adjustment HCC Review - Metro Ohio.
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CPC AAPC or CCA AHIMA certification - 3+ years risk adjustment experience in Medicare advantage or commercial - 3+ years of provider education experience - Knowledge of regulatory/accreditor guidelines - 3+ years of recent and related experience in medical record documentation review, diagnosis coding, and/or auditing.
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At HPOne San Antonio, TX Heres what youll do : As a Medicare Sales Consultant you will attend a 40-hour, instructor-led learning session to prepare for passing the state health exam. Medicare Sales Consultant (College/Military.
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Coordinates, identifies, and/or initiates significant change MDS’ - Is prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and maintains PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator - Remains current with American Association of Nursing Assessment Coordinators (AANAC) requirements.
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SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare Advantage plans, serving more than 270,000 members in California, Arizona, and Nevada.
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Utilization review, prior authorization, Care management, medicare, referral coordinator, utilization management, Case management, interqual, ncqa, ncqa standards. Utilization review,prior authorization,Care management,medicare,referral coordinator,utilization management.
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TRANZACT is a leading performance sales and marketing agency specializing in the Medicare Advantage, Medicare Supplemental, and Life and Supplemental Insurance space. Proficiency with PySpark, Python, SQL, Excel, and data visualization tools (Tableau, Power BI, etc.
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medicare advantage jobs Company: Capital Markets Placement
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