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Provide non-clinical support to the Customer Solution Center Appeals and Grievance Specialists for L. A. Care's Medicare Advantage program. Under the supervision of the Appeals and Grievance Manager, assist with soliciting non-clinical information from Participating Physical Group (PPG) and specialist concerning follow care related to care management.
$47,840 - $68,474 a yearFull-timeExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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The successful candidate will possess expertise in quantitative data analysis, use of large datasets, including SEER-Medicare, health plan data, electronic health records and complex manipulation of other patient and health care data.
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Strong understanding of health plan, healthcare provider & vendor contracting and regulatory requirements, ideally in a PACE, Medicare Advantage (MAPD), or Medicare Prescription Drug Plan (PDP) organization.
$95,000 - $125,000Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Our Medicare Sales Field Agents sell individual health plan products and educate beneficiaries on our services in a field setting. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
$31,500 - $43,400 a yearExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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Knowledge of eligibility requirements for Medi-Cal, Hospital Presumptive Eligibility Program, Medicare, Covered California, Knowledge of eligibility requirements for Medi-Cal, Hospital Presumptive Eligibility Program, Medicare, Covered California.
Full-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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Demonstrated knowledge of case management, discharge planning, transition of care, transfer coordination; Medicare, Medicaid, Title 22, NCQA, JCAHO, URAC, and other federal/state/local regulations.
$148,800 a yearExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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In this role, you will be responsible for conducting in-home wellness risk adjustment assessments for Medicare and other populations. Your primary objective will be to assess the overall health and well-being of member beneficiaries to ensure accurate and comprehensive risk adjustment coding, leading to greater value-based care.
$120,000 - $150,000 a yearFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Other Benefits : Transportation passes for employees and/or eligible dependents; Medicare; Tuition reimbursement; credit union membership; SDI; Deferred Compensation Plan; 401(K) Thrift plan; EAP; Medical and Dependent Care Flexible Spending Accounts; Flexible work schedules; and Jury Duty Pay.
Full-timeExpandApply NowActive JobUpdated 20 days ago - UpvoteDownvoteShare Job
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Background with Medi-Cal, Medicare, managed care, and PPO insurance. This will involve providing quality control checks on paper claims; processing tracers, denials and related correspondence; initiating appeals; and drafting, composing, and submitting appeal letters.
$26.85 - $35.41 an hourExpandUpdated 6 days ago - UpvoteDownvoteShare Job
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Provide support for all lines of business, including Medicare Advantage, Medicaid, individual market, employer group plan offerings and services, and ancillary lines. Provide support for all lines of business, including Medicare Advantage, Medicaid, individual market, employer group plan offerings and services, and ancillary lines.
Full-timeRemoteExpandUpdated 4 days ago - UpvoteDownvoteShare Job
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Documentation meets all third-payer (Medicare, PPO, Work Comp and HMO) and regulatory requirements. Master's Degree; AHA Basic Life Support for Healthcare Professional (AHA BLS Healthcare) - American Heart Association; California Speech-Language Pathologist - CA Speech-Language Pathology & Audiology & Hearing Aid Dispensers Board; Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) - The American Speech-Language-Hearing Association (ASHA.
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Requires attention to detail and strong knowledge of healthcare regulations, such as HIPAA, Medicaid, and Medicare. The role is responsible for full compliance and high performance in our Medicaid and Medicare managed care contracts.
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Completes Medicare Compliance and obtains ABN if necessary. Obtains pre-certification, referral or authorization number and updates patients file. Performs required pre-certification, credit referral or deposit collection.
$37,600 - $56,400 a yearPart-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Didactic and conference schedules) Manages New Innovations (NI) for program, including demographics, scheduling, evaluations, procedure logs, duty hours, and Medicare reimbursement. Position Overview The position of Graduate Medical Education (GME) Program Coordinator (PC) is critical to the success of the residency and fellowship training programs at Cedars-Sinai.
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Must be a commercial insurance provider and/or Medicare provider; Quivvy Tech is the fastest growing national telemedicine network in the U.S. We have a triage call center where all patients are pre-screened for medical necessity and to confirm compliance with legal and regulatory standards all while ensuring a positive patient experience.
ExpandApply NowActive JobUpdated 3 days ago
medicare job in Los Angeles, CA
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