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Knowledge of CMS risk adjustment and reinsurance payment processes and audits for Medicare programs. Measure capture rate of Hierarchical Condition Categories (HCC)s and diagnosis codes related to Risk Adjustment programs to improve and optimize program targeting for Medicare and commercial exchange populations.
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Job Description Job Summary: WELLBE INTRODUCTION The WellBe care model is a Physician Led Advanced Practice clinician driven geriatric care (care of older adults) team focused on the care of the frail, poly-chronic, elderly Medicare Advantage patients.
Full-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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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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Upon commencement of your employment, Solomon Page offers automatic enrollment into ReviveHealth, which offers concierge, membership-based access to virtual primary care, urgent care, mental health therapy, a vision program, and prescription medications.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Adminstrative duties not limited to printing, sorting mail, and shipment of open enrollment materials. As a strong representation of Bond Benefits Consulting, a team of AssuredPartners, the Employee Benefits Enrollment Specialist should epitomize Bond's culture of Trust, Accountability, and Teamwork.
$42,000 - $48,000 a yearExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to: Value Based Payment, fee-for service, capitation and various forms of risk, ASO, etc.
$59,810.6 - $129,589.63 a yearFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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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.
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Leads the strategic planning development related to Medicare/ Medicaid reimbursement and Managed Care Case Management. Familiarity with Medicaid and Medicare regulations required. The RN Director of Clinical Documentation Reimbursement (CDR) is responsible for the overall operational and strategic planning of the Clinical Documentation and Reimbursement (CDR) Department and Health Information Management (HIM) Department.
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The Public Health Project Specialist will be responsible for ensuring that studies are added to the platform as well as training and supporting team members on using the platform to help them meet their participant enrollment goals.
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Employment in the Cooperative Summer School program is enrollment/registration driven. NYS teacher certification or certification as a school counselor (preferred). Employment in the Cooperative Summer School program is enrollment/registration driven.
ExpandApply NowActive JobUpdated 9 days ago - 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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Serve as a resource to territory's accounts and Janssen Biotech staff regarding local, regional and national payer policies; reimbursement regulations and processes (i.e., eligibility and benefit verification, pre-authorization, billing, coding, claims, and appeals/grievances); practice management; Medicare and Medicaid rules and regulations; OSHA; HIPAA; and state-specific clinical staff licensing / certification requirements for product compounding, admixture, administration and monitoring.
Full-timeExpandApply NowActive JobUpdated 22 days ago - UpvoteDownvoteShare Job
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Campus Collaboration:Fully support the RIT Strategic Plan and the Enrollment Management division enrollment goals. This includes: Undergraduate Admissions, Graduate Admissions, Student and Academic Advising Services, Registrar, Student Financial Services, Co-op, Student Employment, Marketing, Study Abroad/RIT Global, Residential Life, Dining Services and academic departments.
(student)ExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Supports the university-wide analytical function of the institutional research office, including predictive and other advanced analytics, enrollment projections, and decision support studies. Extract, transform, analyze, and summarize data using various tools including SAS, R, SQL and Tableau.
ExpandApply NowActive JobUpdated 11 days ago - UpvoteDownvoteShare Job
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Outstanding knowledge of Case-Mix, Federal Medicare PPS process, and Medicaid reimbursement. Develops and updates assigned policies and procedures; Ensures nursing department compliance with Medicare, Medicaid, and other insurance reimbursement regulations, including but not limited to documentation.
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enrollment medicare jobs in Rochester, NY
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