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The Risk Adjustment Reporting & Analytics Manager is an opportunity to lead complex analytics projects and initiatives for Cigna’s Medicare Advantage Risk Adjustment business. The Risk Adjustment Reporting & Analytics Manager is an opportunity to lead complex analytics projects and initiatives for Cigna’s Medicare Advantage Risk Adjustment business.
Full-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Minimum 5+ years’ experience in risk adjustment coding activities in a Medicare/ACA or provider organization to include RAPS, EDPS, RADV Audits and all CMS/HHS, and other regulatory Guideline required.
Full-timeExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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The ACO Coding Auditor is responsible for reviewing medical records and identifying, collecting, assessing, monitoring, and documenting claims and encountering information as it pertains to Medicare Risk Adjustment.
Full-timeExpandApply NowActive JobUpdated 2 months ago - UpvoteDownvoteShare Job
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Today Ideal Concepts is established with over 100 carrier partners in 50 states selling Health, Medicare, Life, Property & Casualty as well as a suite of supplemental insurance products. Today Ideal Concepts is established with over 100 carrier partners in 50 states selling Health, Medicare, Life, Property & Casualty as well as a suite of supplemental insurance products.
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Ideal Concepts, Inc. has impacted the insurance industry for over 20 years by simplifying the sale of insurance products from carrier to agent to client through cutting edge technology. Ideal Concepts started in the insurance sales and technology industry in 2005 under the leadership of founder and President, John Pequeno.
Full-timeRemoteExpandApply NowActive JobUpdated 20 days ago - UpvoteDownvoteShare Job
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The RNAC/MDS Coordinator provides accurate and timely MDS assessments in accordance with the state and federal regulations while coordinating the Resident Assessment Instrument (RAI) process in accordance with Medicare, Medicaid, OBRA and other payor program requirements.
$95,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Demonstrated awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems is helpful. Works with the Landmark Health Medical Director, Director of Health Services, Corporate Director of Health Services, and UM staff in the development and/or implementation of medical management policy, clinical protocols, utilization management guidelines, and quality management programs.
ExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Duties and Responsibilities:Provide legal counsel to healthcare providers on regulatory matters, including fraud and abuse, state licensure, corporate practice of medicine, and Medicare and Medicaid billing and reimbursement.
Full-timeExpandApply NowActive JobUpdated 2 months ago - UpvoteDownvoteShare Job
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Understanding of national and state legislative, Medicare, Medicaid, and private payer initiatives affecting reimbursement of pharmaceutical and biotechnology products. Serve as subject matter expert for internal stakeholders and external office staff regarding the Medicare treatment guidelines, Medicaid Managed Care, commercial plans, policy changes, formulary status and the impact of healthcare reform on coverage.
$170,200 a yearFull-timeExpandApply NowActive JobUpdated 20 days ago - UpvoteDownvoteShare Job
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Supports CFO and other finance staff, as needed, for various health center reports such as Medicare cost report, grant budgeting, 401k reconciliations, payroll reporting, etc. Responsible for technical assistance and general support of grants administration and financial reporting, including federal grants (such as the 330 FQHC and Ryan White Part C grants), state grants (such as the Pennsylvania Challenge Grants), and private grants.
Full-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Understanding of NCQA guidelines for credentialing, primary source verification process, PA State, Medicare and Medicaid enrollment guidelines, physician sanctions review. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region.
Full-timeExpandApply NowActive JobUpdated 22 days ago - UpvoteDownvoteShare Job
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Lead program-specific professional development teams in ensuring staff development-related compliance with regulations and requirements through identified federal or state systems of oversight including, but not limited to, state departments of health (DOH), departments of human services (DHS), departments of social services, and other state agencies; Centers for Medicare and Medicaid Services (CMS); and Community Behavioral Health (CBH.
Full-timeExpandApply NowActive JobUpdated 23 days ago - UpvoteDownvoteShare Job
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Filing system includes, billing files created weekly for CBH, MA, Medicare, BHSI, & Magellan. Enters all rejections received from other payors (i.e. MA, Medicare, BHSI, Magellan, etc.) Filing system includes, billing files created weekly for CBH, MA, Medicare, BHSI, & Magellan.
Full-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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The position is responsible for upholding RHD values and for adhering to the standards of DDAP, OMHSAS, Magellan, Medicare, and any other funding or licensing bodies. The position is responsible for upholding RHD values and for adhering to the standards of DDAP, OMHSAS, Magellan, Medicare, and any other funding or licensing bodies.
$29.83 an hourFull-timeExpandApply NowActive JobUpdated 13 days ago - UpvoteDownvoteShare Job
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Make an impact as our VP of Legal Affairs and Deputy General Counsel by having a strong understanding of mergers, acquisitions, health care joint ventures, real estate transactions, federal and state tax and exemption issues, and Medicare reimbursement.
Full-timeExpandApply NowActive JobUpdated 2 months ago
medicare job in Darby, PA
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