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Bonus PointsCertified Risk Adjustment Coder (CRC) or similar certificationExperience coding in multiple different Electronic Medical Record (EMR) systems. We're hiring a Risk Adjustment Coder Specialist to join our Risk Adjustment team.
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RN - Care ManagerMedicare - DSNP/MAP*Fully Remote*Join our team at Village Care as a Full Time RN- Care Manager!
$105,000 a yearFull-timeExpandApply NowActive JobUpdated 13 days ago - UpvoteDownvoteShare Job
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The Medicare Sales Representative is involved with health education through the distribution of health ed. In addition, the Medicare Sales Representative provides Facilitated Enrollment, helps facilitate the continuance of health insurance, and offers assistance with recertification.
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Supports the regular development and review of Sales Department regulatory compliance policies and procedures and its related activities for the Marketplace, Medicare, and MLTC/MAP lines of business.
$85,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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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.
$93,000 a yearPart-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Certified Professional Coder (CPC)Certified Professional Biller (CPB) Athena EMR Experience: Demonstrated proficiency and hands-on experience with Athena Electronic Medical Records (EMR) system.
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Medicare 2540 Cost Report for Post-Acute Care facilities. Medicare 224 Cost Report for Federally Qualified Health Centers (FQHC) Assist in the preparation of Medicare & Medicaid Rate Analysis.
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External reviewers include New York State (Fair Hearings), Centers for Medicare and Medicaid Services (CMS), Independent Review Entities and Quality Improvement Organizations. Reviews information available from Medicaid, Medicare, other payers, and/or professional medical organizations regarding benefit levels and medical necessity criteria.
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No more Medicare, Manager Care, gate-keepers, HMO’s, welfare, DRG’s, RVS codes, prior authorizations, PPO’s or other third party payers. In a given surgical office, the Physician is part of a team that includes not only the Clinical Staff, but Senior Counselors (non-clinical team members who meet with and educate patients on hair loss and hair restoration), Front Office Assistants, and the Office Manager.
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All OPWDD employees must be eligible and maintain eligibility for full and unconditional participation in the Medicare and Medicaid programs. The liaison will also assist in facilitation of alternate placement for lesser needs individuals into voluntary provider agencies, family care, non-certified housing, and self-direction.
$91,381 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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Convergence - Job Title: Pediatric Field RN | Bronx Location: Bronx, NY Schedule: Days Salary: Beginning at $95,000 Company Overview: A distinguished Home Healthcare Agency based in New York with a coveted 5 Star Rating for excellence in Patient Care, as recognized by Medicare & Medicaid Services, who is committed to delivering top-tier services, specializing in skilled nursing, physical therapy, and pharmacy assistance - focusing on aiding seniors in maintaining their independence at home.
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Manage all benefits and entitlements applications and recertification’s for Medicaid/Medicare, SSI/SSDI/SSP/SNAP, work incentives and all other benefits entitled to each individual in the IDD program.
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Under the Medicare and Medicaid Programs, Reform of Requirements for Long-Term Care Facilities, as outlined in Section § 483.60 of Title 42 of the Code of Federal Regulations all newly-hired Dietitians, Levels I-IV assigned to a Post-Acute Care (Long-Term Care) facility, are required to have New York State Certification, issued by the New York State Education Department (NYSED), as a “Dietitian-Nutritionist” at the time of hire.
$45 an hourExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Relevant certifications (e.g., Certified Professional Coder (CPC), Certified Fraud Examiner (CFE), Certified Internal Auditor (CIA. We are seeking a highly skilled and experienced professional to join our team as a Health Plan Operations Audit Expert with a specialization in Call Center and Claims Integrity Auditing for Medicare/Medicaid SNP (Special Needs Plan) claims.
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