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The Senior DME billing code compliance and appeals specialist will play a crucial role in ensuring that our DME product complies with the billing codes and regulations set by Medicare and all federally funded payers.
Full-timeExpandApply NowActive JobUpdated 20 days ago - UpvoteDownvoteShare Job
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Cigna-HealthSpring is contracted with Medicare for PDP plans, HMO and PPO plans in select states, and with select State Medicaid programs. – Wellcare is the Medicare brand for Centene Corporation, an HMO, PPO, PFFS, PDP plan with a Medicare contract, and is an approved Part D Sponsor.
ExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
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The Medicare Compliance Analyst & Support Specialist position is an essential role within Fallon Health's Medicare compliance program and includes activities such as the collection and review of data universes for accuracy to protocols, data analysis to identify risks and trends, developing data visualization and dashboards to portray information to Fallon Health Leadership up to the Audit & Compliance Committee of the Board.
Full-timeRemoteExpandApply NowActive JobUpdated 28 days ago - UpvoteDownvoteShare Job
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Are in compliance with regulatory agencies, including but not limited to, Covered California, the Centers for Medicare and Medicaid Services (CMS), the California Department of Health Care Services (DHCS), and the California Department of Managed Health Care (DMHC), in addition to collaboration with, inter-departments to ensure member needs are met while simultaneously building strong peer relationships.
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Correspond with medicare and various insurance companies to facilitate obtaining pertinent data on compliance, authorizations, verifications, progress notes, medical necessity guidelines and precertification and pre-authorization requirements.
ExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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The Assistant General Counsel I supports and reports to the Chief Legal Officer and provides legal advice on a wide variety of matters related to Community's Medicare, Medicaid and Marketplace programs and operations including contracting, quality, utilization management, network management, privacy and security, litigation, fraud, waste and abuse, and contractual and regulatory compliance.
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Administers MercyOne’s CMS-based Shared Savings/ACO Programs (e.g., Medicare Shared Savings Program (MSSP. She/he will work collaboratively with the MercyOne Operations Team to provide oversight to PHSO colleagues related to compliance and contracting, among other functions.
Full-timeExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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Audit operational areas and delegated vendors for compliance and ensure Jefferson Health Plans (JHP) is meeting applicable federal and state laws and regulations, and contractual requirements as set forth by all regulatory entities including but not limited to Pennsylvania State regulatory agencies (DHS, DOH and PID) and Centers for Medicare and Medicaid (CMS.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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A Medicare Sales Representative focuses on helping people who are eligible for Medicare find a plan that meets their needs and aids them with the enrollment process. What Does a Medicare Sales Representative Do.
$75,000 - $140,000 a yearFull-timeExpandApply NowActive JobUpdated 12 days ago - UpvoteDownvoteShare Job
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Other: Knowledge of a combination of health insurance and Medicaid, Medicare, Marketplace operations, regulations and compliance requirements. Maintain current knowledge, monitor changes, and provide research on Community's legal requirements including but not limited to licenses, certifications and accreditations as well as the requirements of the Texas Administrative Code, Texas Insurance Code, Health and Human Services Commission (HHSC), Texas Department of Insurance (TDI), Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), and other regulatory entities.
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We have a proven lead system that will keep you busy all year long, not just during Medicare season of AEP and OEP. There is no cost for leads, no administrative fees, and no cost of training. Medicare Advantage experience is a must.
$75,000 - $140,000 a yearFull-timeExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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Whether our clients need a Medicare Supplement or an Advantage Plan, Long Term Care planning, Life Insurance, Annuities, Medicaid help, or Income and Future Planning, we have access to a wide selection of programs to meet their needs.
$75,000 - $140,000 a yearFull-timeExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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Assist in the preparation of the Medicare Cost Report and the HRSA UDS report. Knowledge of grant accounting and compliance including OMB circulars. Manages and Oversees Community Health Center Accounting for post award grants, ensuring compliance with funding source guidelines, revenue cycle management, accurate submission of financial reports, audits.
Part-timeExpandApply NowActive JobUpdated 28 days ago - UpvoteDownvoteShare Job
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Grow with our compliance and anti-fraud team with the responsibility to perform advanced analyses to ensure the integrity of Medicare and Medicaid programs. Accredited Healthcare Fraud Investigator (AHFI), Health Care Anti-Fraud Associate (HCAFA), Certified Insurance Fraud Investigator (CIFI), Certified Financial Crimes Investigator (CFCI), Certified Fraud Examiner (CFE), and Certified in Healthcare Compliance (CHC) Certifications.
$73,100 - $166,000 a yearFull-timeExpandApply NowActive JobUpdated 19 days ago - UpvoteDownvoteShare Job
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You perform your sales duties following the Centers for Medicare and Medicaid Services (CMS) Medicare marketing guidelines. Your responsibilities include working with seniors to determine their eligibility for Medicare benefits.
$75,000 - $140,000 a yearFull-timeExpandApply NowActive JobUpdated 9 days ago
medicare compliance jobs Title: specialist Company: Metroplus Health Plan
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