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Demonstrated understanding of insurance, Medicaid, Medicare billing requirements. State License with one or more of the following licenses: Licensed Clinical Social Worker (LCSW), Licensed (Clinical) Professional Counselor (LPC or LCPC), or Licensed Marriage and Family Therapist (LMFT.
Part-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Under the direction of the PFS Manager, the Senior Government Billing and Collections Representative is responsible for a variety of payer yield activities related to accounts reimbursed by a government payer, including Medicare, Medicaid, TRICARE, and Veterans Administration, among others.
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Adjudicate all claims types including Dental, Vision and Medical claims for inpatient and outpatient facilities, physician claims, In and Out of Network claims, Medicaid reclamation (HIPD), outpatient lab and radiology, accident and Third-Party Liability (TPL) claims, by calculating benefit due to approve or deny, based on SPD and within accepted corporate cycle timeframe.
$33,280 - $47,271 a yearFull-timeExpandApply NowActive JobUpdated 22 days ago - UpvoteDownvoteShare Job
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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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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.
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The Legal Specialist Sr. is responsible for leading support staff and providing legal support services for multiple Medicaid states, enterprise-wide functions, and/or the most complex litigation through highly complex legal assignments and projects, which utilize a recognized area of specialization and knowledge specific to the company.
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Minimum of 5 years prior supervisory or demonstrated leadership experienceExtensive knowledge of Revenue Cycle, patient registration, coding, billing, regulatory requirements, billing compliance, business operations, financial systems and financial reportingThorough understanding of Medicare, Medicaid, HMOs, PPOs, and private insurance companies, as well as an understanding of ICD-10 and CPT coding, EMR PQRS, and Medicare Quality Initiatives.
Full-timeRemoteExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Life insurance, annuities, disability insurance, medical long term care, homeowner’s insurance, auto insurance, umbrella liability policies, and public insurance programs such as Social Security, Medicare, and Medicaid will be explored.
Part-timeExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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The position will be a key member of the cardio-obstetric team and will collaborate with the submission of quality measures to the Centers for Medicaid and Medicare Services (CMS) and Partnership for Quality Measurement (PQM), advocate for clinical guideline development with national professional organizations; conduct data analyses of UCI's cardio obstetric database; conduct studies, including community-engaged research, on patient CVD risk behaviors and social determinants of health.
ExpandApply NowActive JobUpdated 6 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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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.
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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.
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The Black PEARL Model (PI: Candice Lucas, MD & Carol Major, MD) aims to integrate care systems in partnership with a BIPOC (Black, Indigenous, and People of Color) community-based doula workforce in Orange County, recruited and trained with HERStory, Inc., and establish systemic integrated care with UCI Health, the only academic health center in Orange County.
ExpandApply NowActive JobUpdated 11 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 17 days ago - UpvoteDownvoteShare Job
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Familiarity with insurance verification processes, including Medicaid and commercial insurance plans. Verify insurance coverage and eligibility for mental health patients, including Medicaid and private insurance plans.
ExpandApply NowActive JobUpdated 13 days ago
medicaid job Company: Association For Community Affiliated Plans in Fountain Valley, CA
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