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The Risk Adjustment Coding Specialist works in a team environment and is responsible for reviewing clinical documentation and coding using HCC (Hierarchical Condition Category) and M.E.A.T (Monitored, Evaluated/Assessed/Addressed, Treated) standards while adhering to coding guidelines established by the Centers for Medicare and Medicaid Services (CMS.
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If appointed you may be required to become an enrolled Medicare provider; obtain and provide to your employer a National Provider Identifier (NPI) number issued by the National Plan and Provider Enumeration System (NPES); and otherwise actively participate to the degree necessary to allow for your services to be billed through Medicare and Medicaid.
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If appointed you may be required to become an enrolled Medicare provider; obtain and provide to your employer a National Provider Identifier (NPI) number issued by the National Plan and Provider Enumeration System (NPPES); and otherwise actively participate to the degree necessary to allow for your services to be billed through Medicare and Medicaid.
$52,009 - $56,146 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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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 of businesses. As an CCM Nurse Practitioner/ Physician Assistant per diem you will provide care to Optum members and be responsible for the delivery of medical care services in a periodic or intermittent basis.
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NPI number and be Medicare enrolled with a Medicare Identification Number (or PTAN) (or eligible for Medicare Enrollment within 6 months of hire). The Pediatric Endocrinology and Diabetes Advanced Practice Provider will serve as a Full Time Advanced Practice Provider to provide care to patients at The Joslin Diabetes Center.
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This organization is a Medicare Advantage Institutional Special Needs Health Plan (ISNP) for long-term nursing home residents. The plan covers all medically necessary and preventive services covered under Medicare Parts A, B, and D. They are strongly focused on improving their members' physical, mental, and social well-being through personalized clinical care and therapies.
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The Medicare Senior Sales Manager will supervise Medicare Sales Field Agents who sell the portfolio of products offered to the Medicare population. The Medicare Senior Sales Manager leads an internal sales team while also responsible for support and growth of External Partner Production.
$62,000 - $85,300 a yearFull-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Outstanding knowledge of Case-Mix, Federal Medicare PPS process, and Medicaid reimbursement. Develop and update assigned policies and procedures; Ensures nursing department compliance with Medicare, Medicaid, and other insurance reimbursement regulations, including but not limited to documentation.
Up to $44 an hourFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Must have NPI number and be Medicare Enrolled with Medicare Identification Number (or PTAN) OR be eligible for Medicare Enrollment within 6 months of hire (eligibility criteria for NP requires National Certification through AANP or ANCC, and Master's Degree.
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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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If you are appointed and lose the ability to bill through Medicare and Medicaid, you may be terminated from your employment. In order to be eligible for appointment and to maintain employment, you cannot be listed as an excluded individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or Federally assisted program.
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Coordinates overall functions including but not limited to: NYPORTS, NIMRS, Justice Center, STARS/ClearSight, Centers for Medicare and Medicaid Services (CMS) death reporting in restraints; ensuring that reporting criteria are met.
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Hueman is actively hiring Nurse Practitioners and Physician Assistants to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Baldwinsville, NY.This unique opportunity adapts to your lifestyle, giving you the freedom to achieve your professional goals on your terms,all while enjoying a schedule designed with your preferences in mind.
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Applies knowledge of various Medicare, Medicaid, and other third party billing rules. The Accounting Manager prepares monthly financials statements, assists in cash flow projections, annual budget, tax returns and cost reports.
$80,000 - $90,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Knowledge of specialty pharmacy dynamics, buy and bill process and Medicare Parts A, B, C and D, as well as Medicaid and Commercial Payers. Knowledge of specialty pharmacy dynamics, buy and bill process and Medicare Parts A, B, C and D, as well as Medicaid and Commercial Payers.
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medicare job in Clay, NY
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