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Oversight of Medicaid claims, Tricare and Coverage Gap processing operations with Third Party vendor and coordination of quarterly cash flow monitoring with Treasury. Insure approval workflow of Medicaid, Tricare and Coverage Gap claims follows approval matrix and completes within payment due date cycle.
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Support the managing partner with drafting planning instruments including Wills, Trusts, Powers of Attorney, Health Care Directives, beneficiary designations, and advise on tax and Medicaid implications and complex asset protection plans including family partnerships and irrevocable trusts; supervise signing ceremonies.
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Experience working with payors/market access, CED, co-insurance/deductibles, HCPs and governmental entities such as VA, DOD, Tricare, etc. Experience working with payors/market access, CED, co-insurance/deductibles, HCPs and governmental entities such as VA, DOD, Tricare, etc.
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Oversee Medicaid claims, Tricare and Coverage Gap processing operations with Third Party vendor and coordination of quarterly cash flow monitoring with Treasury. Ensure approval workflow of Medicaid, Tricare and Coverage Gap claims follows approval matrix and completes within payment due date cycle.
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Knowledge of Medicaid Drug Rebate Statute, Veterans Health Care Act, Average Sales Price, and 340B program. Engage with senior commercial leaders in a broad range of areas outside of market access such as sales, medical, regulatory, operations, finance, supply chain, manufacturing, pharmacovigilance, external affairs, and other functions.
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Education, Knowledge, Skills and Abilities Preferred: Experience working with Epic. Understanding of national quality performance measurement and reporting, particularly those identified by the Center for Medicare and Medicaid Services (CMS), the State of New Jersey Department of Health, and the Joint Commission.
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Knowledge of Medicare Part D, Medicaid, Medicaid HMO plans, & commercial insurances. PharmScript is one of the nation’s leading pharmacies, partnering with long-term and post- acute care facilities to supply medications to thousands of residents and patients.
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Parker at Somerset was honored with a Five-Star rating from the Centers for Medicare and Medicaid Services (CMS), in all categories, which places the community as one of the top-rated nursing homes in the state.
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These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Become a part of our caring community and help us put health first Are you passionate about the Medicare population, looking for an opportunity to work in sales, and wanting the ability to directly impact your own income potential.
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The candidate should also understand and or have experience managing patients with Medicare and Medicaid insurance. 2-4 years billing and coding experience within healthcare industry. Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching.
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Knowledge of terminally ill patients and their families along with understanding of hospice concept; knowledge of roles of all disciplines providing hospice services; excellent patient assessment skills; good oral and written communication; thorough knowledge of managed care principles, regulatory guidelines (i.e., Medicare, Medicaid, and human resource) management principles.
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Serving millions of Medicare and Medicaid patients, Optum is the nation's largest health and wellness business and a vibrant, growing member of the UnitedHealth Group family. For NPs: Graduate of an accredited master's degree in Nursing (MSN) program and board certified through the American Academy of Nurse Practitioners (AANP) or the American Nurses Credentialing Center (ANCC), Adult-Gerontology Acute Care Nurse Practitioners (AG AC NP), Adult/Family or Gerontology Nurse Practitioners (ACNP), with preferred certification as ANP, FNP, or GNP.
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Knowledge of NJ financial programs (Medicaid, Charity Care). Assures and completes a pre-determination for insurance coverage for all new and recurring outpatients seeking services at CSH. These service lines include Occupational, Physical, Speech Therapy, Psychology, Chronic Pain Evaluations, Botox and Alcohol Blocks.
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Performs detailed patient billing: Billing inclusive of Medicare, Medicaid billing for inpatient claims, as well as multiple payers for Durable Medical Equipment. Experience with Medicare, Medicaid and Durable Medical Equipment billing.
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Monitor client accounts to ensure balances remain at required levels as determined by Medicaid and Social Security so they continue to remain eligible for benefits. We are seeking a qualified professional who is responsible for establishing, reconciling and maintaining consumer financial accounts, paying consumer bills, completing cash disbursements, tracking and monitoring all account activity.
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tricare medicaid jobs in Bridgewater, NJ
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