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Communicates and advises appropriate internal and external stakeholders on Medicare Compliance and Medicare Set-Aside (MSA) matters including, but not limited to, lien negotiation efforts, MSA submissions and/or general information.
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Leads and assists with external inspections and surveys conducted by New York State Department of Health (NYSDOH), Food and Drug Administration (FDA), Center for Medicare & Medicaid Services (CMS), and United Network for Organ Sharing (UNOS/OPTN.
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Maintains accurate, truthful, and complete records as required by laws and agency policy including, but not limited to the New York State Education Department (SED), The Speech-Language Pathology Guidelines, New York State Office of the Professions, the Office for People With Developmental Disabilities (OPWDD), Medicaid, Medicare, insurance companies, municipalities, Department of Health, school districts, and other regulating bodies as necessary.
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The Pharmacy Billing Specialist is responsible for electronic billing of Medicare, Medicaid and Third Party Insurance claims, utilizing Frameworks LTC Pharmacy system. Electronic billing of Medicare, Medicaid and Third Party Insurance claims utilizing Framework LTC Pharmacy system.
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Coordinates, as appropriate, practice interactions and/or follow-up actions with other CINQCARE functional areas, including, but not limited to, Network Management/Provider Relations, Medical Economics, and Health Home. Works closely with appropriate company resources for (Medicaid VBP, Medicare ACO and Health Homes) to monitor and report metrics such as resource utilization, patient satisfaction, and other key performance indicators.
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This includes Early Childhood billing, Medicare/Medicare HMO's, Blue Cross, IHA, Univera, Medicaid/Medicaid HMO's, Contract & Private Patient billing. Prior Practice Management system and electronic claim filing experience including maintenance of data tables Knowledge of Medicare and Medicaid billing guidelines.
$19.97 - $29.95 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Completes all Medicare Prospective Payment System (PPS) Minimum Data Set (MDS) and/or OBRA assessments for both subacute and long-term care. Demonstrated experience and background in Medicare Reimbursement including CMI and PDPM payment model.
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Submits statistical reports to the Business Office staff for Medicare billing payments, and completes assessment forms upon request. Submits statistical reports to the Business Office staff for Medicare billing payments, and completes assessment forms upon request.
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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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Description & Requirements Maximus is currently hiring a Senior Project Manager responsible for overseeing the Contact Center Operations Medicare Advanced Resolution Center Team. This position is fully remote and will require a home office.
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Maintain broad and current knowledge of Medicare and Medicaid regulatory and billing requirements, managed care contracting and reimbursement issues. Expert understanding of billing Medicaid, Medicare, Managed Care organizations and commercial insurances.
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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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Medication Assisted Treatment (Suboxone, Vivitrol, Methadone) Homeless Outreach and Supportive Housing Services. BestSelf Behavioral Health, Inc. is the largest community-based behavioral health organization serving children and adults with mental health and substance use disorders in WNY. We provide easy access to a full continuum of person-centered, trauma-informed behavioral health treatment, rehabilitation and recovery services.
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NOTE: As a condition of continued employment, incumbents must obtain certification as a Nurse Practitioner by the American Nurses Credentialing Center or other national certifying body recognized by Health Care Financing Administration (HCFA) within nine (9) months of their appointment to this title as required by Medicare.
$129,494 - $183,236 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Oversees and participates in daily operations of patient billing and claim submission and follow-up with payers in accordance with Medicare, Medicaid, governmental and/or third-party payer billing guidelines.
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medicare job in Tonawanda, NY
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