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Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Part D (Pharmacy Benefit design and coverage policy) a plus. The Field Reimbursement Manager will execute the collaborative territory strategic plan through partnership with internal and external stakeholders, including acting as an extension of patient support program and in other collaboration with other partners.
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Demonstrated understanding of insurance, Medicaid, Medicare billing requirements. Current, active, and unencumbered FL State License as a Licensed Independent Social Worker (LCSW), Licensed Professional Clinical Counselor (LPC ), Licensed Marriage and Family Therapist (LMFT) or License Clinical Mental Health Counselor (LCMHC.
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The Infusion Reimbursement Manager is responsible for managing the billing and collection function for all payer groups including Medicare / Medicaid. The Infusion Reimbursement Manager is responsible for managing the billing and collection function for all payer groups including Medicare / Medicaid.
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The ASC Medical Billing professional will also work closely with our team to ensure compliance with medical terminologies, denials, ICD-10 coding, and Medicaid, Medicare and commercial insurance policies.
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Conduct Medicare, VA, and Medicaid payment policy research and analysis, develop strategic recommendations. Broad knowledge of Medicare, managed care, third party payers, and Medicaid required; knowledge of Medicare rulemaking process, Durable Medical Equipment benefit category preferred.
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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.
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Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
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As part of the Signify Health's Member Engagement team, you will contact members of various Medicare Advantage and Medicaid health plans by phone to offer, explain, and schedule a free in-home or virtual healthcare evaluation.
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Proven track record of success in field sales or grassroots marketing; ideally field sales with a focus on senior value-based care models or Medicare Advantage. Proven track record of success in field sales or grassroots marketing; ideally field sales with a focus on senior value-based care models or Medicare Advantage.
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Adheres to best practice by following all regulatory, federal and state recommended practices and guidelines as stated by (but not limited to) AAMI (Association of Advancement of Medical Instrumentation), AORN (Association of Perioperative Registered Nurses), The JC (Joint Commission), CMS (Centers of Medicaid & Medicare), APIC (Association for Professionals in Infection Control and Epidemiology) and SGNA (Society Gastrointestinal Nurses Association.
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Familiarity with key data sources for healthcare analysis (eg, Medicare claims, Medicare Part D data, commercial claims data, Medical Expenditure Panel Survey data, Medicare Current Beneficiary Survey data.
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Keeps abreast of changes in Medicare, Medicaid, and insurance providers regarding pre-certification procedures. Keeps abreast of changes in Medicare, Medicaid, and insurance providers regarding pre-certification procedures.
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General understanding and knowledge of the Center for Medicare and Medicaid Systems (CMS), the Joint Commission (TJC), the National Association for Quality Assurance (NCQA), and the Massachusetts State Regulations as they pertain to credentialing of Medical Staff members and Allied Health professionals.
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Be at the forefront of designing and delivering Medicare and other health technology solutions that push boundaries and create new opportunities for our clients. From rapid deployments to entire transformations, you'll deliver leading edge Medicare strategy and operations capabilities to our clients.
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Oak Street Health is on a mission to Rebuild healthcare as it should be, providing personalized primary care for older adults on Medicare, with the goal of keeping patients healthy and living life to the fullest.
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