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This job will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits.
ExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
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Emergency Department registration experience, strongly preferredKnowledge of various insurance plans (HMO, PPO, POS, Medicare, Medicaid) and payors, required. Emerus’ leading national health system partners include Allegheny Health Network, Ascension, Baptist Health System, Baylor, Scott & White Health, Dignity Health St. Rose Dominican, The Hospitals of Providence, INTEGRIS and MultiCare.
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As part of the Signify Health’s Member Engagement team, you will contact members of various Medicare Advantage and Medicaid health plans by phone to offer, explain, and schedule a free in-home or virtual healthcare evaluation.
Full-timeRemoteExpandApply NowActive JobUpdated 11 days ago - UpvoteDownvoteShare Job
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EAP Worklife Analyst - Medicare Team Afternoon Shift page is loaded. EAP Worklife Analyst - Medicare Team Afternoon Shift. EAP WorkLife Analyst - Medicare Team. non-profit organizations, hospitals, advocacy agencies, or government provided services.
ExpandApply NowActive JobUpdated 11 days ago - UpvoteDownvoteShare Job
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Acts as an advisor and consultant in the establishment of operational policies of the practice to include: Purchasing and capital allocations; Managed care plan participation; Budget and practice expenses; Medicare/Medicaid participation; Billing and collection of professional fees; Personnel management and related policies; Risk management and quality assurance; and Coding compliance.
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Coordinating internal Skilled Nursing Facility operations to assure compliance with CMS Medicare guidelines, Managed Care case management policy and procedures, and Medicaid reimbursement criteria to improve quality census mix.
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Knowledge of third party reimbursement, including Medicare, Medicaid and commercial insurance required. The OHH Pre-Cert Veification Coordinator will work in a fast-paced environment this position is responsible for pre-registration of patients, to include pre-authorization, insurance verification, calculation of patient portion prior to a patient's testing or procedure and arrangements with patient for payment at time of service prior to admission to OHH and/or its clinics.
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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.
$122Full-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Whether it’s holding a PhD-level deep dive into understanding fairness and underlying bias in machine learning models, debating the merits of a Scandinavian design philosophy in our UI/UX, or writing responses for Medicare rules to influence U.S. health policy, we prioritize sharing our findings across the team and helping each other be successful.
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In conjunction with Generations Advantage (GA) leadership and EMT, analyze, develop, and submit Medicare Advantage and Prescription Drug (MA/PD) plan Bid Pricing Tools (BPTs) in compliance with CMS regulations and timelines to meet corporate objectives for growth and profit margin.
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As the MDS Coordinator (RN) or (LVN) your focus will be Medicaid and Medicare reimbursement. Tracking Medicare resident benefit days, validating daily Medicare census, and coordinating this information with management to assure accurate billing.
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The Coding Specialist is responsible for abstraction or accurate coding of procedures from the medical record to ensure optimal reimbursement while staying compliant with OIG, CMS, the local Medicare Administrative Contractor, all system policies and procedures and any state and other regulatory agencies.
Full-timeExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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As a Medicare Sales Agent (internally titled Advocate Agent) you'll enjoy unlimited earning potential, the convenience to work from home, access to best-in-class paid training, and potentially the opportunity to move into a leadership role.
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Your primary objective will be to assess the overall health and well-being of Medicare beneficiaries to ensure accurate and comprehensive risk adjustment coding, leading to greater value-based care.
ExpandApply NowActive JobUpdated 22 days ago - UpvoteDownvoteShare Job
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Medicare agents - sell Medicare Advantage, Medicare Supplement and PDP from home this AEP! Assurance is looking for licensed and experienced insurance sales agents to help Medicare beneficiaries find the plan that is right for them.
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medicare job in Oklahoma City, OK
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