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Required - High School diploma or equivalent plus 2 years' experience in Medicare/Medicaid and commercial billing - preferably in Durable Medical Equipment setting. Perform DME billing for Medicare, Medicaid, Tricare, and other private insurances.
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LMHC, LMHCA, LCSW, LCSWA, PH.D. Psy. D or RN or equivalent licensure with MHP recognition. Education: Master's Degree or higher from an accredited program in social work, mental health or related behavioral field and or RN with MHP recognition.
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Perform denials, incorrect payments/underpayments, past due receivables, and complete follow-up processing of Medicare and other participating commercial insurances in a timely manner. Full-time (scheduled 72 hrs or more per pay period) - Day.
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Experience or understanding of Medicare and Medicaid claims, ICD10 codes, HCPCS, Diagnosis Related Groups (DRG). 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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Follow Medicare guidelines, the appeals and grievance process, and the members' rights and responsibilities as stated by the Division of Medical Assistance Program (DMAP aka HSD) Oregon Health Authority (OHA) and Centers for Medicare and Medicaid Services (CMS.
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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. This is NOT a remote / 'work from home' position.
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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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MetroPlus Health 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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DEPARTMENT DESCRIPTIONSamaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services.
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Our health plan serves more than 640,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans. Required Certification from either AHA, ASHI, or Red Cross.
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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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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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Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: ASAP Duration: Ongoing Employment Type: Staff Agency: The Christ Hospital Home Health Care Our culture and people are what set us apart from other post-acute care providers.
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An Excluded Party is a person that the federal or state government found not eligible to provide care and services in a Community that receives Medicare or Medicaid funding.
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Participate in audits from the State and Federal Governments as well as investigations or focused audits from the Office of Inspector General; responsible for collecting and compiling the data required for various audits and appeals such P14 audit, DSH audit, I&R appeal, 340B audit, Medicare Wage Index and Medicare Cost Report audits.
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medicare medicaid rn or jobs Title: coordinator Company: Unitedhealth Group
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