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We are excited to announce three immediate openings for experienced candidates in the following roles: Medical Biller, Medicare Advantage Follow-Up Specialist, and Commercial Follow-Up Specialist.
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QCO has a high volume of Medicare members that need follow up after hospital discharges for medication reconciliation, chronic blood pressure outreach calls, osteoporosis programs and post-emergency visit follow up calls.
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Resolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health. Develops and maintains current knowledge of state and federal regulatory requirements related to all aspects of grievances and appeals for Medicare managed care organizations, Medicaid, home health care, managed long term care as well as contractual requirements.
$93,000 a yearExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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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.
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Responsible to follow-up with healthcare insurance companies on outstanding medical claims and appeals. We are looking for an experienced medical biller /AR specialist for a specialty surgery group full-time in Odenton, MD. Must have experience working directly for a private practice, not a hospital or billing company, doing billing, coding, charge entry and AR work only.
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Work with the start-up team, CTMS and UW Clinical Trials Office (CTO) to review billing calendars, Medicare Coverage Analysis (MCA), and financial entries and bill routing. In collaboration with the start-up team, identify research and Medicare coverage billing structure for post-award cost recovery.
$4,409 - $5,929 a monthTemporaryExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Understanding medical coding, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management. Experience and Competencies: 2+ years of billing experience (medical/insurance billing preferred) Knowledge of Medical Terminology, CPT, ICD-10 and HCPCS Codes.
$20 - $21 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Prior experience with Medicare Managed Care (Medicare Advantage) preferred. The Coder, Risk Adjustment position provides thorough concurrent, prospective, and retrospective review of ambulatory medical record clinical documentation to ensure accurate and complete capture of the clinical picture, severity of illness, and complexity of the patient.
$28.15 an hourFull-timeExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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Investigates and coordinates the resolution of routine and complex grievances and appeals according to defined processes and procedures ensuring that required timeframes and regulatory requirements are met, accurate and timely follow up is completed and activities are documented as required.
$93,000 a yearPart-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Florida Medical Clinic Orlando Health invites you to explore the Family Practice/Internal Medicine opportunities with a thriving physician-led, professionally managed healthcare system. Now a part of Orlando Health West, Florida Medical Clinic Orlando Health continues to be the one of the largest multi-specialty groups in the Hillsborough and Pasco county areas.
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Our Certified Medical Billing and Coding Specialist program is completely self-paced, so it can be done around YOUR schedule. Have you thought about becoming a certified medical billing and coding specialist but it's just too expensive at the $1000-$50,000 cost, it takes WAY too long to finish, AND all without any assistance in actually finding work.
$57,000 a yearInternRemoteExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Processes electronic and telephonic level of care determinations; Processes electronic and telephonic authorization requests for ongoing services; processes electronic and telephonic requests for psychiatric hospitalization and other crisis services; make decisions related to medical necessity and the utilization of services.
$41.41 an hourExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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The Drug Use Policy Pharmacist is responsible for the identification, execution, and follow-up on high cost medication usage evaluations and recommendations for the patient population within Cedars-Sinai Medical Network Foundation.
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Preferred 2 years Medicaid, Medicare and medical billing experience. Job Summary Assist in billing and cash application of Medicaid/Medicare/DME/Home Infusion claims.
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Is prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and maintains PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator.
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follow up medical billing managed medicare jobs Company: Enovis in Amarillo, Texas
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