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Regulatory Associate Responsibilities: Conduct legal research and analysis related to provider reimbursement issues, Medicare and Medicaid appeals, audits, and internal investigations. The Regulatory Associate will primarily focus on provider reimbursement issues, Medicare and Medicaid appeals, and audits and internal investigations, supporting the firm's robust and sophisticated regulatory and reimbursement practices.
$185,000 - $285,000RemoteExpandApply NowActive JobUpdated Today - 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.
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Educate payers (Health plans, Medicare, Medicaid), key decision makers (P&T members, opinion leaders, pharmacists), agents (specialty pharmacy, GPO, and PBMs); differentiate products based on clinical (efficacy & side effect profiles) and economic data to support formulary decisions.
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Managing Medicare Medical Review and Denials process in conjunction with Director of Rehabilitation, the facility, and therapy staff. Managing Medicare Medical Review and Denials process in conjunction with Director of Rehabilitation, the facility, and therapy staff.
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Maintains internal database of Medicare marketing materials; includes but is not limited to data entry, data validation, and executing monthly QA processes. Utilizes HPMS interface to upload and track Healthcare Foundation Health Plan Medicare marketing materials.
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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 2 days ago - 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 eligible to participate in Medicare, Medi-Cal, F-PACT and other federal health programs. Experience working with electronic health records required, eClinicalWorks preferred. Participates in chart review and quality assurance activities as part of APLA Health Quality Management Program.
$111,508.8 - $149,684.13 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Imperial Health Plan of California, Inc., is licensed by the California Department of Managed Health Care as a health care service plan in accordance with the Knox-Keene Act to provide Medicare Advantage covered services, including a Medicare Advantage Prescription Drug plan, and a Chronic Condition Special needs plan over numerous counties in California.
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POSITION SUMMARY Enables patients to secure access to care at PIH Health facilities by performing all tasks related to registration and pre-registration of outpatient and inpatient accounts. Bilingual PRODUCTIVITY: Completes a minimum of registrations but strives for up to + registrations per hr shift which includes scanning documents, insurance verification and securing upfront collections.
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Preferred knowledge of Medicare and Commercial rules and regulations. A Claims Examiner is responsible for analyzing and the adjudication of medical claims as it relates to managed care. Resolve claims payment issues as presented through Provider Dispute Resolution (PDR) process or from claims incident/inquiries.
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The Patient Account Rep II will bill and transmit EDI claims, Medicare claims, HMO Risk Medicare claims, Commercial Insurance claims, enter client data into the billing systems on a daily basis, research and resubmit claim denials and post payments.
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Managing Medicare Medical Review and Denials process in conjunction with Director of Rehabilitation, the facility team, and therapy staff. Education: Master’s Degree in Speech-Language Pathology from an accredited SLP program Experience: 2-3 years experience in a skilled nursing facility rehab environment or equivalent preferred.
$45 - $55 an hourExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Knowledge of all pertinent federal and state regulations, filing and compliance requirements, both adopted and pending, affecting employee benefits programs, including the ACA, ERISA, COBRA, FMLA, ADA, Section 125, workers' compensation, Medicare, OBRA, and Social Security and DOL requirements.
$25 - $32 an hourExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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California Speech-Language Pathology license or license candidate under state’s regulations. QUALIFICATIONS: Skills, Knowledge and Abilities: Knowledge in Speech-Language Pathology evaluation and treatment as they relate to medically based speech, language, and swallowing disorders.
$48 - $58 an hourExpandApply NowActive JobUpdated Today
medicare job in Los Angeles, CA
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