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This position will support Medicare Risk Adjustment activities including ACO REACH, MSSP and Medicare Advantage activities. Serves both internal and external customers, identifies opportunities for improvement throughout the Medicare risk adjustment process.
$100,000 - $231,500 a yearFull-timeExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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Job Description :Audit & Reimbursement III - Medicare Cost Report AuditLocations: This is a virtual position; the ideal candidate will live within 50 miles of an Elevance Health PulsePoint location.
Full-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Perform complex Medicare cost report audits, serving as an in-charge auditor assisting other auditors assigned to the audit. Under guided supervision, the Audit and Reimbursement III will gain experience on complex issues involving the Medicare cost report and Medicare Part A reimbursement.
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Advanced in Medicare/Medicaid regulations, health care terminology, and various software packages and applications such as Medicare Cost Report software (HFS Software) Proficient in Medicare/Medicaid regulations, health care terminology, and various software packages and applications such as Medicare Cost Report software (HFS Software.
RemoteExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Assist in the preparation of the Medicare & Medicaid cost reports for all McLeod entities including hospitals, home office, rural health clinics, home health, hospice and other facilities as required.
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Knowledge of Medicare Important Message, Medicare Secondary Payor, Tricare Third Party Liability; Auto Accident and Work Comp, Medicare/Outpatient Observation Notice. In cases where Tricare or Medicare/Medicare Advantage is primary or secondary, use scripting to review and deliver appropriate regulatory form (Tricare Rights, Tricare Third Party Liability, and Important Message from Medicare (IMM) form.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Work with Finance and Billing to establish a system to approve all pre-transplant charges for inclusion on the Medicare cost report. Completes Medicare time studies in a timely manner for inclusion on the Medicare cost report.
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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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Contractual arrangements include but are not limited to Medicaid, Commercial, Medicare Advantage, Medicare Accountable Care Organization (ACO) Reach, ACO – Medicaid, Capitation and global shared savings/risk.
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The wellness premium applies only to the Blue Cross Blue Shield Hospital Medical Group #14000 plan for non-Medicare eligible active and retired members, non-Medicare-eligible members on LOA or COBRA, and non-Medicare-eligible spouses on active or retired contracts.
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If patient unable to provide insurance, search for potential coverage through MCA for SRS/SCMG and MPV (or Portal) for potential Medicare or Medi-Cal. Knowledge of Local, State, and Federal regulations governing registration/billing activities including Joint Commission, Title XXII, Medicare and Medi-Cal regulations.
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This role is likely to be focused on either Medicaid Managed care data used for compliance and oversight, or on the Medicare Quality Review Program. Applicable languages and platforms include Python, SQL, R, Git for version control, Snowflake, Databricks, and AWS.
Full-timeRemoteExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Preferred Location: Hanover, MD.The Medicare Risk Adjustment Advanced Analytic Senior Is responsible for creating statistical models to predict, classify, quantify, and/or forecast business metrics.
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This trend will continue as roughly 10,000 baby boomers a day enter the Medicare system. Knowledge of Federal, State and Local regulations, Hospice Medicare Conditions of Participation, and HIPAA privacy rules and regulations.
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Job Description :Medicare Risk Adjustment Advanced Analytic SeniorLocation: This position will work a hybrid model (remote and office). Medicare Advantage and Medicaid (Dual Members) risk adjustment experience preferred.
Full-timeExpandApply NowActive JobUpdated 4 days ago
medicare job Company: Visiting Nurse Association Of Central Jersey
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