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Oversees vendor delivery to our Medicare Advantage and Exchange customers, including contract management, strategy development, operational delivery and invoicing. Engages with external resources, including the consultant community, in order to evaluate and understand the current and emerging market for Medicare Advantage and Exchange programs.
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We not only partner with commercial health plans, but are also a licensed Medicaid and Medicare provider and see patients across the lifespan. Do you have experience using an Electronic Medical/Health Record (EMR or EHR.
$66,000 a yearRemoteExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Quickly grasp new concepts and product offerings, such as Major Medical, Medicare Advantage, Medicare Supplement, Prescription Drug Plans, and other ancillary health products. As a Medicare Sales Agent (internally titled Advocate Agent) you'll enjoy unlimited earning potential, the convenience to work from home, access to best-in-class paid training, and potentially the opportunity to move into a leadership role.
$60,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories CRC (HCC)CPMA (Certified Professional Medical Auditor), CDEO (Certified Documentation Expert Outpatient) or CPC-I (Certified Professional Coding Instructor) preferred.
$18.5 - $31.72 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Minimum of Two (2) or more years office administration experience, preferably in a medical setting; Prior medical coding experience preferred. All Healogics employees must perform their job responsibilities according to all Healogics policies, Hospital policies, as well as to accrediting organizations, federal and state regulation, and to the Centers for Medicare and Medicaid Services (CMS) guidelines, as applicable.
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This job will deliver value to the Health Plan and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and/or Affordable Care Act (ACA) using skills including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, and Centers for Medicare and Medicaid Services (CMS) coding guidelines.
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RNs Staff will perform clinical reviews of Medicare Part A and Part B claims for Medical Review. Clinical Review of Medicare Part A and Part B Claims for Medical Review with an emphasis DRGs and E&M experience.
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Providing sound, practical judgment in the interpretation and application of relevant laws and regulations, including the Anti-Kickback Statute, the Beneficiary Inducement Statute, Medicare/Medicaid, False Claims Act, Stark Law, HIPAA and state health information privacy laws, and marketing and advertising laws applicable to the marketing and promotion of medical products.
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We offer a wide range of skilled medical home care services and clinical nursing care in the Greater Jacksonville area. Adherence to federal, state, and accreditation requirements, including Medicare and Medicaid regulations.
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Minimum of one year experience in medical billing; knowledge of Medicare, Medicaid, and regulations is preferred. Check out our careers site benefits page to learn more about our comprehensive benefit options, which include medical, vision, dental, 401k, disability, FSA, HSA, EAP, vacation and paid time off.
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Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management.
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The successful candidate will possess expertise in Medicare Advantage risk including HCC; value-based care and a deep understanding of quality metrics such as STARS, HEDIS, CAHPS, HOS and ACO quality measures.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Do you want to assist health care providers and organizations in maximizing opportunities through practice transformation, quality improvement initiatives, and other support services, such as the Patient Centered Medical Home (PCMH) model.
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Medicaid, Long Term Care, Medicare Advantage, Child Welfare, Health Insurance Marketplace, and Case Managment. Additionally, our specialty plans include the Child Welfare Specialty Plan serving children in or adopted from the state's Child Welfare system; the Serious Mental Illness Specialty Plan for people living with serious mental illness; and the Children's Medical Services Health Plan, operated by Sunshine Health on behalf of the Florida Department of Health for children and adolescents with special healthcare needs.
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Founded in 2018, this organization began as an Institutional Special Needs Plan (ISNP) - a type of Medicare Advantage health plan that addresses critical needs of members who reside in skilled nursing facilities (SNFs.
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medical medicare jobs in Tallahassee, FL
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