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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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We CARE for our patients like they are our own FAMILY. Note: The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), require COVID-19 vaccinations for all Medicare and Medicaid certified providers.
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About the roleThe Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work with management to meet communicated single and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS) , and be active and engaged in establishing Risk Adjustment processes.
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This job will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits.
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The Audit and Reimbursement III will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services.
$98,280 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Minimum of one year paralegal/legal assistant experience, preferably in healthcare environment or experience in Medicare or Medicaid provider enrollment or private payer enrollment/credentialing.
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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 devices Policies: Completes all clinical documentation following agency protocol and Medicare/Federal guidelines.
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Represent and serve as point person for the state health plan and Centene Corporation to outside trade groups/stakeholders including state AHIP organization, state medical association, state hospital association and related Medicare and Medicaid business vendors.
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Our firm is seeking an Elder Law and Medicaid Attorney to join our team! Represent clients with Medicaid applications and appeals. If you have experience working with Medicaid applications and helping facilitate the process we invite you to consider this position.
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Senior R programmer with RWD experience and required experience in CMS data (Medicaid, Medicare, etc). Must have hands-on RWD/RWE experience with CMS data, large-scale administrative claims data sources (e.g., MarketScan, Optum, Medicare LDS SAF, Komodo claims), and EHR.
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Perform clinical reviews of Medicare Part A and Part B claims for Medical Review, Redeterminations/Appeals (Appeals), and Prior Authorization requests (collectively, the “Services”) in accordance with CMS (Centers for Medicare & Medicaid Services) requirements.
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Performs all aspects of the insurance verification process for Medicare, Medicaid, and commercial insurance payers to ensure compliance and appropriate assignment for the coordination of benefits.
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The government services support team at Optum has earned the trust of organizations that our entire country relies on; from the Department of Defense and Veteran’s Administration to the teams at Health & Human Services and the Centers for Medicare and Medicaid Services.
$137,800 a yearFull-timeRemoteExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Policies: Complete all clinical documentation following agency protocol and Medicare/Federal guidelines. Operations: Attend in-service training and mandatory agency meetings. Posted job title: Speech Language Pathologist Home Health (Slp), Prn $2,500 Bonus.
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The ideal Candidate will primarily support firm partners and attorneys and be able to assist with client intake, obtaining lien information for ERISA, Medicare, Medicaid, and workers compensation, to include some admin work as needed.
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medicare medicaid jobs Title: service specialist Company: Getixhealth
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