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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), FSA, foreign claims, outpatient lab and radiology, accident and Third-Party Liability (TPL) claims, and Medicare Secondary Payer (MSP) by calculating benefit due to approve or deny, based on SPD.
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Prepare or oversee of FQHC Medicare cost report (multiple reports). Develop, supervise and coordinate all efforts to obtain maximum third party reimbursements; including capitated financial arrangements, incentive payments, and Medicaid/Medicare Prospective Payment agreements.
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Graduate of an approved curriculum in Speech Language Pathology, is able to practice unencumbered, is in good standing with all regulatory agencies and licensing boards, has working knowledge of Medicare and other payer sources, full knowledge of residents rights, exudes professionalism in presentation and able to work on multitasks at the same time.
$50 - $65 an hourExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Managing Medicare Medical Review and Denials process in conjunction with Director of Rehabilitation, the facility team, and therapy staff. Managing Medicare Medical Review and Denials process in conjunction with Director of Rehabilitation, the facility team, and therapy staff.
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Our full-service wound care strategy has added enormous value to patients who are homebound or reside in long-term facilities across the country by providing an array of essential tools including Digital Wound Management, Telemedicine, Advanced EHR systems, Mobile Vascular Assessment, Digital Supply tracking, Advanced Wound Care Dressings as well as a participating Medicare Part B provider.
$80,000 a yearPart-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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To conduct In-home Health Evaluations for Medicare Advantage, Medicaid, and certain commercial plan members. Paid Collaborative Physician Roles available in certain states. to conduct In-home Health Evaluations for Medicare Advantage, Medicaid, and certain commercial plan members.
Starting at $100 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Utilization review procedures include those stated for discharge planning in addition to knowledge of criteria for Medicare, Medicaid coverage and that of HMO or private insurers. Working knowledge of criteria for Medicare, Medicaid, HMO and private insurance coverage.
$42 - $56 an hourFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Excellent knowledge of Case-Mix, the Federal Medicare PPS process, and Medicaid reimbursement, as required. Excellent knowledge of Case-Mix, the Federal Medicare PPS process, and Medicaid reimbursement, as required.
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Maintains and meets expectations on time for all competencies, license, certifications and education requirements as outlined by local administration, Adventist Health (AH), The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS), and all other regulatory agencies.
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Knowledge of financing mechanisms such as Medicare, Medicaid, and Prospective Payment. PACE staff are leaders in the “aging in place” industry and we have had the honor of serving Fresno, Bakersfield and Orange County seniors and their families/caregivers.
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Monitor coding compliance by performing focused audits on high-risk areas identified by the Office of Inspector General (OIG) and the Centers of Medicare and Medicaid Services (CMS). Cedars-Sinai was awarded the National Research Corporation’s Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles.
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Demonstrates knowledge of Hospice Medicare Benefit Program, including levels of care. RN Hospice Clinical Team Manager - Fresno, CA areaLucrative compensation package: Base + Bonus + Free Medical/Vision insurance, generous PTO and other outstanding benefits & employee perks.
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Leads and trains staff in standards of excellence as specified by Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Participates in The Joint Commission survey readiness as assigned.
$127,000 - $142,000ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Coordinates staffing and scheduling to meet census needs. Performs the Joint Commission Tracer field visits for staff team members. Coordinates with Intake Department to ensure timely response to new referrals.
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Conducts frequent supervisory field visits for each team member to support clinical competence. Paid MileageGenerous paid time off (24.5 days per year for FT employees, based on 40-hour work week). Carries out supervisory responsibilities in accordance with company policies and applicable laws.
$127,000 - $142,000ExpandApply NowActive JobUpdated Today
medicare job in Fowler, CA
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