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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 11 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 5 days ago - UpvoteDownvoteShare Job
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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 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 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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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.
ExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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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 7 days ago - UpvoteDownvoteShare Job
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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 Senior Financial Analyst will serve as the Solid Organ Transplant primary internal consultant responsible for providing critical analytical support for regulatory and financial implications of the Transplant components of the Medicare Cost Report (MCR.
ExpandApply 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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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.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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This position serves as the principal HMSA contact for prospective and current Oahu employers and members inquiring about small group health plans, individual plans, Medicare plans and USAble Life product options that are available through HMSA. This position supports HMSA's overall sales and service strategies.
$41,690 - $61,212 a yearExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Responsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD-10 codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures.
$18.5 - $35.29 an hourFull-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Minimum of one year paralegal/legal assistant experience, preferably in healthcare environment or experience in Medicare or Medicaid provider enrollment or private payer enrollment/credentialing.
Full-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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The Nurse Planner works autonomously to develop any and/or all of the following: Life Care Plans, Medical Cost Projections, Limited Medical Cost Projections, Medicare Set-Aside Allocations, Legal Nurse Reviews, Complex Nurse Reviews, Bill Reviews and other reports as needed within their scope of licensing and certifications.
ExpandApply NowActive JobUpdated 10 days ago
medicare job Title: visiting nurse Company: Visiting Nurse Association Of Central Jersey
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