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Minimum of two (1) years' experience working with Medicare and Medicaid insurance as well as commercial insurance plans and benefits (PPO, HMO, POS, EPO, Indemnity) strongly preferred.
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Some tools may include but are not limited to Authorization Guidelines, Insurance Guidelines, Fee Schedules, NPI (National Provider Identifier), PECOS (the Medicare Provider Enrollment, Chain, and Ownership System) and “How-To” documents.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Processes all approved charge corrections timely, verifying proper adjudication for payor eligibility, following all Medicare/Medi-Cal/CCS and other payor guidelines. The Collector performs A/R collections and billing involving multiple insurance contracts & entities.
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Three years of hospital-based registration experience specializing in Managed Care, Medi-Cal, Medicare, and California Children's Services with emphasis on Federal, State, and County eligibility regulations required.
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Requests Insurance authorizations, including Service Authorizations (SARs) for CCS and Treatment authorizations (TARs) for Medi-Cal when necessary for account resolution. Reviews/corrects registration/insurance data utilizing all available sources to obtain correct information.
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Knowledge and Skills: Experience with various insurance products preferred (managed care, Medi-Cal, Medicare, commercial insurances and California Children's Services). Coordinates the scheduling, pre-registration and insurance eligibility for both hospital and physician practice services.
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This compassionate individual is responsible for directing, organizing and scheduling required resident assessments and related documentation for Medicare, Medicaid and private insurance reimbursement with interdisciplinary team for completion of MDS process.
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Knowledge and Skills: Basic knowledge of automated billing, follow-up and adjudication systems required (LLEAP/Epic, Assurance, DDE, FISS, Medi-Cal website, and Noridian Medicare Portal). Job Summary: The Collector performs telephone calls and website checks for claim status from insurance companies, government payers, third party payers, worker's compensation payers, medical groups, outside hospitals, and physician's offices to ensure timely payments for inpatient and outpatient hospital bills in accordance with the terms and conditions of each contract and/or insurance company policies.
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Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval and authorization when required. General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred.
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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.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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The Regional Financial Services Specialist position will require a comprehensive knowledge and understanding of Medicare, commercial insurance and managed care health plans, along with understanding Medi-Cal CERTs to interpret coordination of benefits.
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Whether our clients need Medicare Advantage or Medicare Supplement, Ancillary Plans, Long Term Care planning, Life Insurance, Annuities, Dental and Vision, Income, and Future Planning - AMBA has access to a wide selection of carriers and programs to meet their needs.
$70,000 - $90,000 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago
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