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The Medicare Sales Representative II is involved with health education through the distribution of health ed. In addition, the Medicare Sales Representative II provides Facilitated Enrollment, helps facilitate the continuance of health insurance, and offers assistance with recertification.
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Whether helping you apply for Medicaid, Medicare, arranging CDPAP,or coordinating coverage for Holocaust survivors, we do whatever ittakes to make sure everyone feels right at home. /r/nWhether helping you apply for Medicaid, Medicare, arranging CDPAP,/r/nor coordinating coverage for Holocaust survivors, we do whatever it/r/ntakes to make sure everyone feels right at home.
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Resolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines – Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health. Develops and maintains current knowledge of state and federal regulatory requirements related to all aspects of grievances and appeals for Medicare managed care organizations, Medicaid, home health care, managed long term care as well as contractual requirements.
$93,400 - $116,800 a yearExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Liaison between facility departments & providers, Physician Advisors, Network, Acute facilities, Post-Acute care providers, Community based services, Manage Care Organizations (MCO), Department of Health (DOH), Centers for Medicare and Medicaid (CMS), JCAHO, IPRO, Lavanta, QIO's, and other regulatory agencies and the like.
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Our range of health services include home care, hospice and palliative care for adults and children, rehabilitation and nursing care at Menorah and Isabella Centers, and the research based MJHS Institute for Innovation and Palliative Care. We also offer Elderplan/HomeFirst: health plans for Medicare and dual-eligible individuals.
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Technical skills in healthcare regulatory compliance, Medicare, Medicaid reimbursement, Start, HIPAA privacy laws, Fraud & Abuse and False Claims law. 7 - 10 years’ experience in a multi-entity outpatient healthcare company including both facility and physician providers with focus on health care compliance including Medicare and Medicaid reimbursement regulations, Stark law requirements and fraud and abuse laws.
$225,000 - $275,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.
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The Alaffia team has alumni ranging from Amazon, Goldman Sachs, the Centers for Medicare and Medicaid Services, and other leading healthcare and financial institutions. Deep understanding of health insurance, medical billing and coding, and payment integrity.
$90,000 - $110,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The purpose of a Primary Care Physician at Oak Street Health is to provide equitable and effective value-based healthcare to local Medicare patient populations at our innovative network of neighborhood primary care centers.
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Please ensure that candidates have experience with actually reviewing for Medicaid/ MLTC members not Medicare or IP reviews as those are very different with a different workflow and process. Must have experience in UM, experience with Turnaround Timeframes, good with computer systems and be able to learn a new system, have done clinical reviews and processed denials and partial denial determinations, know MCG and can use it, case presentation for medical reviews, know Medicaid/ Medicare guidelines.
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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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Providing personalized primary care for older adults on Medicare, with the goal of keeping patients healthy and living life to the fullest. Mission-focused career impacting change and measurably improving health outcomes for Medicare patients.
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Position Overview Reporting to the Senior Manager of Medicare Regulatory Compliance, the Medicare Regulatory Compliance Specialist will support the oversight and management of the Medicare Compliance Program.
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Develops, implements, and leads ethics and compliance initiatives across Europe and Israel, including measures to drive compliance to the Code of Conduct, Anti-Corruption Policy, and compliance-related policies.
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Key Competencies include:Foundational Thinking Skills: Review inpatient medical records for identified payer populations (Medicare, Medicaid, Blue Cross/Blue Shield, and others) as directed on admission and throughout hospitalization.
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medicare job Title: compliance specialist Company: Metroplus Health Plan in Bronx, NY
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