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Mount Sinai Rehabilitation Hospital, located on Blue Hills Ave., in Hartford, Conn., is a licensed chronic disease hospital and certified by Medicare as an acute rehabilitation hospital and accredited by the Joint Commission, and the Commission on Accreditation of Rehabilitation Facilities for its General Rehabilitation and Stroke Specialty programs.
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Adjudicate all claims types including Dental, Vision and Medical claims for inpatient and outpatient facilities, physician claims, In and Out of Network claims, Medicaid reclamation (HIPD), FSA, foreign claims, outpatient lab and radiology, accident and Third-Party Liability (TPL) claims, and Medicare Secondary Payer (MSP) by calculating benefit due to approve or deny, based on SPD.
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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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Curana Health serves more than 1,100 senior living community partners across 30 states and participates in both the MSSP ACO, ACO Reach and Medicare Advantage programs with CMS. Backed by more than $300M in venture capital funding, the organization is poised to disrupt care delivery in senior living on a meaningful scale through innovative care models and applied analytics.
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Primary detailing will be focused on Metabolic and Ketogenic Centers, hospitals, Geneticists, Registered Dietitians to include Metabolic and Ketogenic Dietitians, local HHC/ DME partners, State DOH, Pharmacies, and local distributors while supporting local and regional efforts and projects.
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The medical billing and collection specialist must posses critical thinking skills and understanding of Medicare, Medicaid eligibility requirements as well as commercial insurance payer payment methods to correctly record contractual adjustments base on payer contracts or government regulations.
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The Centers for Medicare and Medicaid Services (CMS) COVID-19 vaccine mandate requires staff without an approved medical or religious exemption to be fully vaccinated to be employed in this program.
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LPN role will include the provision of care coordination including Medicare Wellness Visits, Chronic Disease Care Management, and Transitional Care Management for high risk patients. Coordinate and provides Medicare Wellness Visits to eligible patients in the primary care practice.
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Resolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health. Develops and maintains current knowledge of state and federal regulatory requirements related to all aspects of grievances and appeals for Medicare managed care organizations, Medicaid, home health care, managed long term care as well as contractual requirements.
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Officially we title this job a BOM or Business Office Manager, but in other centers it may be called a Medicare / Medicaid Biller or Accounts Receivable Coordinator or even a Financial Services Rep. What’s in it for you: Our patients are loud, happy and eager to say hello to you as you pass by.
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Works closely with the Quality Manager to ensure compliance with statutory mandates, regulatory requirements and accreditation standards of professional organizations such as JCAHO. (Statutory and regulatory requirements include but are not limited to the following: FDA, OSHA, EPA, EMTALA, Medicare and Medicaid provisions of the Social Security Act.
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Medicare approved ambulatory surgery center on site. Historical museum, performing arts, community festivals and celebrations for the family. Friendly community with small-town charm and an abundance of outdoor recreation, including boating, fishing, camping, hunting, hiking, parks, and ATVing.
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Identifies/reviews services requiring pre-authorization/pre-certification by Medicare, Medicaid, Commercial, and Managed Care payers, to ensure provider eligibility requirements are met prior to receiving service.
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At Home Care, Inc. is a Medicare certified home health agency with a 4 STAR Rating for quality and patient satisfaction! Benefits may include medical, dental, vision, and life insurance; mileage reimbursement; paid time off; bi-weekly pay and direct deposit; scholarship opportunities; one-on-one training; recognition programs; referral bonuses; 403(b) with company match; and opportunities for career advancement.
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An active, independent California Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Clinical Psychologist Residence in California Though we do not require our providers to see Medicare patients, you must not have opted out from Medicare Have access to reliable and stable internet while working remotely; experience with Google Suite is a plus.
$68,000 - $100,000 a yearFull-timeRemoteExpandApply NowActive JobUpdated Today
hhc medicare jobs Title: representative Company: Metroplus Health Plan
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