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Strong transactional experience with both traditional and innovative health care delivery entities such as ASCs, ACOs, joint ventures, mergers, acquisitions, at risk insurance products, direct to employer health care contracting, malpractice risk, billing, Medicare compliance, etc.
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Communicates clearly and accurately with others (internally and externally) to provide, exchange, or verify information, answer inquiries, or resolve issues or complaints regarding services provided in the Home and Community-based Services and Texas Home Living Medicaid waiver programs, both of which serve individuals with intellectual and developmental disabilities and must receive specialized services that meet their needs.
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Medicaid Member Support – Tier 1. Kentucky Health Benefits Exchange CSRs answer multiple call types focused on assisting Kentucky Citizens with a variety of different health benefits (such as SNAP, Medicaid and TNAF.
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Must have Medicaid/Medicare or other commercial insurance experience. Your role in our mission Initiate, track and provide award collection correspondence between Revenue Collections and the legal community, effected Medicaid representatives, court, insurance carriers and the Iowa Department of Human Services.
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Responsible for the coordination of the Resident Assessment Instrument (RAI) process to ensure accurate and timely completion of resident assessments in accordance with Medicare, Medicaid, OBRA and other payer program requirements.
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Patient panel is predominately geriatrics with Medicare Advantage coverage. As a member of the Optum Care Delivery team, you’ll be an integral part of our vision to make healthcare better for everyone.
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Preferred Skills:4 years: Experience with Medicaid Enterprise Systems, including Medicaid Management Information Systems (MMIS). Preferred Skills:4 years: Experience with Medicaid Enterprise Systems, including Medicaid Management Information Systems (MMIS.
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Maintain records required for Medicaid billing. ESSENTIAL FUNCTIONS: MAJOR RESPONSIBILITIES AND DUTIES: Implement Individual Healthcare Plan/Individual Education program developed by campus nurse and ARD committee.
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Public Consulting Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives.
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Supervises Home Health Aide and license and documents per Medicare criteria and per agency policy and procedure. Performs all OASIS time point assessment per Medicare Criteria and submits recertification paperwork per agency policy and procedure.
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Billing all insurances within timely filing guidelines, as well as follow-up on all claim in S/T status and those rejections by Medicare / Medicaid to ensure proper payment. Minimum of two (2) years experience in billing or billing management of a home health care company billing Medicare Part A and working with DDE.
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Compliance oversight for "Schedule A" request from carriers, Form 5500, Medicare Part D Disclosures and CMS Reporting, HIPAA and ERISA and COBRA. Compliance oversight for "Schedule A" request from carriers, Form 5500, Medicare Part D Disclosures and CMS Reporting, HIPAA and ERISA and COBRA.
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Research, analyze and reconcile Medicare/Medicaid billing and reimbursement practices. Determine necessity for pre-authorization and obtain authorization for scheduled procedures. Research, analyze and reconcile Medicare/Medicaid billing and reimbursement practices.
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You will assist in the overall clinical operations of the multi-disciplinary team, ensure care is provided to the ultimate satisfaction of patients and their families ensuring clinical appropriateness and quality of patient care according to Medicare regulations.
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Experience with Epic. Knowledge, Skills and Abilities Knowledge of and/or experience with Medicare, Medicaid and commercial insurance plan registration, and eligibility verification. We offer the following benefits to eligible team members: Medical, Dental, Vision, Flexible Spending Accounts, PTO, 401(k), EAP, Life Insurance, Long Term Disability, Tuition Reimbursement, Child Care Assistance, Health & Fitness, Sick Child Care Assistance, Development and more.
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medicare medicaid jobs Company: Public Consulting Group in Texas
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