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The Director, MA & Medicaid Contracting on the Strategic Payer Partnerships team will execute Aledade's Medicare Advantage and Medicaid value-based care contracts with national and regional health plans as we help primary care providers shift into value-based care.
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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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Reporting to the Senior Manager of Medicare Regulatory Compliance, the Medicare Regulatory Compliance Specialist will support the oversight and management of the Medicare Compliance Program.
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MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
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We are looking for compassionate and caring Medicaid Eligibility Specialist to join our LIFE New Jersey team. Medicaid Eligibility Specialist. Work with families and participants in a timely manner to assist them in completing the paperwork needed for Medicaid eligibility.
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Experience in health care, health plans, Medicaid Managed Care Plans (MCPs), Medicare Advantage, Medicare Part D, Special Needs Plans (SNPs), and/or Medicare-Medicaid Plans (MMPs)/Cal MediConnect.
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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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1+ years of experience in medical records coding (HCC Coding) with knowledge of Medicare, Marketplace, and Medicaid risk adjustment is required. 2+ years of experience in coding with knowledge of Medicare risk adjustment (HCC Coding.
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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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If employed at one of our senior living communities that receives Medicare or Medicaid funding, team members must not be considered an "Excluded Party" as defined by the U.S. Department of Health and Human Services, any state Medicaid Programs, and any additional federal and state government contract programs.
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Working knowledge of Medicare, Medicaid, MVA, Workers Comp and private insurance billing and reimbursement processes, legal requirements knowledge. Partner with Billing Specialists to ensure accurate processing and billing of Medicare, Medicaid, Managed Care, Worker’s Compensation, other government programs, motor vehicle, personal injury and protections, third party payer experience, self-payer/uninsured and commercial insurance processing patient claims in accordance with payer requirements and organization policy.
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Regulatory Knowledge: Extensive knowledge of third-party payer regulations and contracts, including Medicare, Medicare Advantage, Medicaid, and non-governmental payers. The ideal candidate will possess a deep understanding of third-party payer regulations and contracts, including Medicare, Medicare Advantage, Medicaid, and non-governmental payers.
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Knowledge of external review organizations (i.e. Managed Care, Medicare, Medicaid, State gatekeeper for Medicaid). LMHC, LMHCA, LCSW, LCSWA, PH.D. Psy. D or RN or equivalent licensure with MHP recognition.
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Communicate referral dispositions to Medicaid and BHO funders and obtain pre-authorization for those meeting service criteria. The Intake Specialist is responsible for completing the behavioral health intake process as prescribed by Medicaid and WAC for each child assigned which includes: completing a diagnostic formulation using clinical and diagnostic assessment tools, gathering child and family medical and behavioral health information, completing complex behavioral health intake documentation and determining initial treatment areas for intensive behavioral health services.
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Heritage Manor is rated a five-star skilled nursing facility by the Centers for Medicare & Medicaid services. $250 after the completion of 6 months of service. Heritage Manor is rated a five-star skilled nursing facility by the Centers for Medicare & Medicaid services.
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medicare medicaid service specialist jobs Title: service specialist Company: Philips
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