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Abides by all documentation and coding conventions, ethical and professional standards and rules established by the Center for Medicare and Medicaid (CMS), and the American Health Information Management Association (AHIMA) for assignment of diagnostic and procedure codes and ultimately a working DRG.
Full-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Comply with all regulatory and quality agency standards including: Centers for Medicare and Medicaid Services (CMS), Department of Managed Health Care (DMHC), Department of Health Services (DHS), and accreditation bodies’ standards such as the National Commission of Quality Assurance (NCQA) as it relates to care management activities.
ExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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Monitors for inquiry requests from the Department of Managed Health Care (DMHC), Medicare Complaint Tracking Module (CTM) from the Centers for Medicare Medicaid Services (CMS), the Medicare Quality Improvement Organization (QIO) and the State Hearing Office from Department of Social Services (DSS.
ExpandApply NowActive JobUpdated 15 days ago - UpvoteDownvoteShare Job
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Secures medical necessity checks/verification in accordance to Centers for Medicare & Medicaid services, verifies insurance, benefits, coverage & eligibility, completes assigned registration financial clearance work lists activities, obtains insurance authorizations for scheduled & unscheduled Hospital services, and secures inpatient visit notification to payors.
Part-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Experience in health and human services domains such as eligibility, enrollment, Medicaid, child welfare, and child support systems. Experience in health and human services domains such as eligibility, enrollment, Medicaid, child welfare, and child support systems.
Full-timeExpandApply NowActive JobUpdated 16 days ago - UpvoteDownvoteShare Job
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The Contracts Specialist Sr will monitor policy updates to ensure compliance with operational and Centers for Medicare and Medicaid Services (CMS) and Department of Healthcare Services (DHCS) regulatory requirements and complete all required documentation.
$70,000 - $114,268 a yearFull-timeExpandApply NowActive JobUpdated 11 days ago - UpvoteDownvoteShare Job
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Healthcare industry experience as it relates to risk adjustment, medical claims submissions, adjudication and payment, eligibility, encounters file management in particular for Medicaid/Medicare populations.
Full-timeExpandApply NowActive JobUpdated 21 days ago - UpvoteDownvoteShare Job
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Ensures all clinical operations comply with Medicare and Medicaid guidelines and other managed care policies. We are one of only two certified Pediatric ICUs in Orange County and the only hospital in Fountain Valley and Huntington Beach with a Level III Neonatal ICU. We’re proud of the efforts of our physicians, nurse and staff who strive to provide you with the best care possible.
Full-timeExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Knowledge of medical terminology, HIPAA, Medicaid, Medicare, Insurance and FDCPA. Ideal candidates will possess claims processing/medical billing experience and a competitive desire to maximize returns.
$17 an hourFull-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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6 months of Medi-Cal/Medicaid or health services experience. Addresses member and provider inquiries, questions and concerns in all areas including eligibility, enrollment, claims or authorization status, benefit interpretation and referrals/authorizations for medical care in-person or telephonically.
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Answer incoming telephone calls, make out-bound calls, and track all paperwork necessary to submit enrollment and renewal for prospective Medicaid patients. Answer incoming telephone calls, make out-bound calls, and track all paperwork necessary to submit enrollment and renewal for prospective Medicaid patients.
Full-timeRemoteExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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The ideal candidate will also be knowledgeable in Medicare, Medicaid, and private insurance, as well as the ability to complete relevant insurance documentations. The ideal candidate will also be knowledgeable in Medicare, Medicaid, and private insurance, as well as the ability to complete relevant insurance documentations.
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At least 2 years of experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines. Our company is continuing to grow and we're looking to add a Prior Authorization Specialist to support our patient care operations department.
ExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Health care facilities in California are licensed, regulated, inspected, and/or certified by a number of public and private agencies at the state and federal levels, including the CDPH Center for Health Care Quality (CHCQ) and the U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS.
$7,767 - $9,658 a monthFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Submits necessary documentation to regulatory/accreditation entities, such as the California Department of Public Health (CDPH), The Joint Commission (TJC), and Centers for Medicare and Medicaid (CMS.
ExpandApply NowActive JobUpdated 4 days ago
medicaid job Company: Association For Community Affiliated Plans in Anaheim, CA
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