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Work with Finance and Billing to establish a system to approve all pre-transplant charges for inclusion on the Medicare cost report. Completes Medicare time studies in a timely manner for inclusion on the Medicare cost report.
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Assesses, via electronic systems, patient’s insurance plans and benefits, such as MassHealth eligibility and Medicare benefits and facilitates coordination with Patient Financial ServicesPrepares, explains to patients, and documents delivery of the Medicare Important Message and Medicare Outpatient Observation Notice.
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Expert knowledge of Medicare, MassHealth and commercial insurance pre-claims requirements, regulations and guidelines. This position reports directly to the Patient Financial Administrator and works closely with school clinics it supports: Dental Faculty Practice, Craniofacial Pain and Sleep Center, Oral Medicine, Oral and Maxillofacial Pathology and Tufts Dental Facilities, the Pre-doctoral (students), Postgraduate (residents) Specialty clinical treatment areas, which includes: Endodontics, Orthodontics, Periodontics, Prosthodontics, Pedodontics, Oral and Maxillofacial Surgery, AEGD and Geriatric Dentistry.
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Responsible for Quality & Controls Assurance programs, activities and reviews, including claims reviews; call center and digital communications reviews; Medicare Risk Adjustment, HCC, clinical and coding reviews; DRG and medical records reviews; technology/systems and coding upgrade and implementation reviews (e.g. final user acceptance testing, etc.
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The Biostatistician will lead a comprehensive analysis of youth aged 13-25 using the newly released Transformed Medicaid Statistical Information System Analytic Files (TAF), which include inpatient, outpatient, emergency department, and pharmacy claims from across the US from 2016-2021 from the US Centers for Medicare and Medicaid Services (CMS.
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Eliot's One Care Health Home program is an innovative Care Management approach for members with complex medical, behavioral health, and social needs who are dual eligible, having both Masshealth and Medicare benefits.
$50,000 a yearFull-timeExpandApply NowActive JobUpdated 26 days ago - UpvoteDownvoteShare Job
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The PRN Social Worker provides psychosocial evaluation and counseling patients who reside in a Skilled Nursing Facility or rehabilitation center regarding dialysis related issues; works in collaboration with the multidisciplinary treatment team to incorporate psychosocial needs/concerns in planning care; documents on patients in dialysis chart in keeping with facility policies to meet Medicare and Quality Assessment Performance Improvement (QAPI) requirements.
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Oversee the Contact Center department and provides strategic direction and operational insight for CCA's Medicaid/Medicare Dual Eligible enrollees and MAPD Plan members. Yes. Direct Reports Include the Director of Member Service, Director of Provider Service, Senior Director of Member Communications, Manager of Training and Quality, Director of Business Strategy and Technology, Director of Member Experience and Improvement, Senior Director of Consumer Affairs, and the Director and Senior Consultant for Consumer Experience.
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We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses. The Marketing Promoter is responsible for participating in events marketing, particularly targeting Medicare Advantage Plan prospects.
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Advises transplant candidates on insurance and funding options including providing information regarding alternate funding and choices of insurance coverage i.e., Medicare and Medicaid eligibility, COBRA, Social Security Disability, retirement plans, etc.
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Proven ability to work with Legislative Staff, Federal organizations (Center for Medicaid and Medicare (Client), and Food and Nutrition Service (FNS), Providers, and Advocate Organizations, and Commonwealth's Human Resources Division (HRD) and Collective Bargaining Organizations, on program/project goals, status, etc.
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With support from a new 5-year R01 award from the NCI, our team of cancer care delivery and equity investigators, healthcare policy experts and statisticians is conducting a comprehensive analysis of inequities in opioid management among Medicare and Medicaid-insured patients across the cancer trajectory.
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Monitor Centers for Medicare and Medicaid Services (CMS) reimbursement policies and keep abreast of trends in reimbursement and health policy that affect Merz Therapeutics' products and the markets in which they compete.
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An Enrollment Specialist is a member of the Patient Engagement Specialist (PES) team, telephonically educating and enrolling patients in a Medicare-sponsored care coordination program designed to help the patient better manage their chronic illnesses (diabetes, high blood pressure, COPD, etc.
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Identifies, reports, and resolves issues relating to all revenue cycle IT platforms (including but not limited to Epic, NThrive, Medicare FISS, Trizetto, and HealthRise). Identifies, reports, and resolves issues relating to all revenue cycle IT platforms (including but not limited to Epic, NThrive, Medicare FISS, Trizetto, and HealthRise.
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medicare job in Everett, MA
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