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Experience with CMS Medicare Advantage Risk Adjustment Data Validation and HCC coding desired. Experience with CMS Medicare Advantage Risk Adjustment Data Validation and HCC coding desired. Must hold a current credential for one of the following: RHIA, RHIT CCS, CCS-P, CPC, CPC-H, and/or CRC. If not CRC certified, you must attain the certification within the first year of your employment date.
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Knowledge of health care, managed care, Medicare or Medicaid. Pay Range: $46,500.00 - $79,200.00 per yearCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.
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Oak Street Health is on a mission to 'Rebuild healthcare as it should be , providing personalized primary care for older adults on Medicare, with the goal of keeping patients healthy and living life to the fullest.
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These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company.
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Exhibit Competency: Demonstrate proficiency in all areas of the Resident Assessment Instrument (RAI), Care Planning, Prospective Payment System (PPS), Medicare, and, when applicable, Medicaid Case Mix.
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Knowledge of insurance guidelines including HMO/PPO, Commercial, Medicare, Medicare Advantage, TN Care's, Medicaid and Private Pay. The purpose of the Reimbursement Insurance Verification Specialist is to obtain and verify a client's commercial insurance coverage and to ensure procedures are covered by an individual's insurance.
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All Healogics employees must perform their job responsibilities according to all Healogics policies, Hospital policies, as well as to accrediting organizations, federal and state regulation, and to the Centers for Medicare and Medicaid Services (CMS) guidelines, as applicable.
$20.81 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Quality Support Specialist of Blount Memorial Physicians Group assists in quality program initiatives set forth by the Quality and Pharmacy Operations Manager of BMPG which include but are not limited to third party payor incentive programs, revenue capture programs, coding and documentation compliance, Medicare quality initiatives.
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Exclusive Insurance Payor Access: Only SonderMind provides complimentary credentialing for both traditional Medicare and Medicare Advantage plans, including Humana and United Healthcare.
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Our 1,000+ clinicians serve more than 1,500 senior living community partners across 33 states, and Curana participates in various innovative CMS programs (including owned-and-operated Accountable Care Organizations and Medicare Advantage plans.
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Knowledge of Workers’ Compensation, Medicare and/or clinical standards of practice. It operates more than 800 onsite and nearsite wellness centers in 45 states and Guam, delivering care through the Digital Wellness Center and onsite, nearsite, mobile, and event solutions.
Full-timeExpandApply NowActive JobUpdated 13 days ago - UpvoteDownvoteShare Job
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Awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems. 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.
Full-timeWork from homeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Qualifications: Knowledge of the case management process, needs of geriatric patients, health care settings, working knowledge of funding resources such as Medicare Part A, B, C & D, Medicaid, Managed Care and other private insurances.
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Topics include but are not limited to HIPPA, Medicare, Fraud and Abuse, Coding Requirements, Claims submission Process, Marketing Practices, Antitrust, Taxation, Antireferral, etc. Design, select, implement and maintain databases and information relative to mandatory annual training, report line call volume and cataloging, report line call file tracking, OIG/GSA Sanctions Listings, Management Certification and Disqualified Persons/Related Parties.
Full-timeExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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Must be fully licensed by the State Board to provide therapy independently and without supervision (e.g., LPC, LCSW, LMFT, LMHC, LCPC, LCSW-C, LISW, or LP). Thoughtful client matching and dedicated coaches to grow your practice: We help you get paired with individuals who are ideal clinical matches so that you can control and personalize your caseload, and a dedicated coach to help you help your clients, no matter what your specialty, from pediatric to geriatric mental health, trauma, anxiety or addiction, we help you help others.
$99 an hourFull-timeRemoteExpandApply NowActive JobUpdated 10 days ago
medicare job in Knoxville, TN
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