- Accounting Now (Tampa, FL)
- We are hiring Revenue Cycle Specialists who excel in Medicare Collections for our Revenue Operations DepartmentSpecialists in this role will contact Medicare ... resolve all unpaid or underpaid system debit balances on Medicare insurance claims; includes but is not limited to...insurance claims; includes but is not limited to remit review , calling payer(s) and clinics, rebilling, navigating payer portals,… more
- Fidelity TalentSource LLC (Westlake, TX)
- Job Description:Squad Leader, Fidelity Medicare ServicesThe\u00A0RoleFidelity s Healthcare Group has launched a new Medicare business that helps individuals ... select and enroll in quality Medicare coverage. As an early member of this new...not limited to a criminal, civil litigations and regulatory review , employment, education, and credit review (role… more
- Dialysis Clinic, Inc. (Sacramento, CA)
- …loaded and coordinates with internal departments to ensure appropriate billing system resolutions. Review Medicare and other primary payments to ascertain which ... reimbursementEmployee assistance programWellness programAmong others Responsibilities What You Can Expect: Review patient's insurance coverage upon admission to determine coordination… more
- Blanchard Valley Hospital (Findlay, OH)
- …to address insurance discrepancies prior to service. Duty 3: Completes Medical Necessity review for all Medicare patients ensuring that an ABN is printed ... in Healthcare related field Knowledge of CPT Coding, ICD 9 Codes, and Medicare Reimbursement Issues PHYSICAL DEMANDS This position requires a full range of body… more
- U of C NORC (Bethesda, MD)
- …of health care delivery, from private marketplaces and employer-sponsored insurance to Medicare and Medicaid; from large health care systems to small clinics; and ... R&D costing, and regulatory complianceDemonstrated comprehensive knowledge of the Medicare prescription drug coverage and payment policy rules, regulations, and… more
- Staffing Now (Miami, FL)
- …and CMS. Position is key to PACE's revenue and expense process, procuring Medicare rate tables, processing provider claims for expenses by service line, ensuring ... client enrollment for accurate capitation reimbursement from Medicaid and Medicare , generating accruals for accounting.Essential Job FunctionsCompletes all medical… more
- Staffing Now (Miami, FL)
- …and CMSPosition is key to PACE's revenue and expense process, procuring Medicare rate tables, processing provider claims for expenses by service line, ensuring ... client enrollment for accurate capitation reimbursement from Medicaid and Medicare , generating accruals for accounting. Essential Job Functions Completes all medical… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …changes. Takes the lead for the organization's Accounts Receivable review and analysis Minimum Job QualificationsLicensure or other certifications: Educational ... current with updated coding and billing regulations.Prepares, monitors, and files Medicare and Medicaid Cost Reports assuring maximization of reimbursement from… more
- Careers Integrated Resources Inc (Atlanta, GA)
- …accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment and/or professional medical ... risk adjustment model regulations. This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the… more
- Careers Integrated Resources Inc (Atlanta, GA)
- …the following programs; including but not limited to, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, Commercial IVA (Initial Validation Audit), and ... Medicare RADV (Risk Adjustment Data Validation). HCC Risk Adjustment...95% accuracy on coding quality audits. Responsibilities: Compile chart review findings statistics, analyze data results and implement meaningful… more
- Careers Integrated Resources Inc (Costa Mesa, CA)
- …coding and/or underpayments. . Reports new/unknown billing edits to direct supervisor for review and resolution. . Has a strong understanding of the Revenue Cycle ... forms. . Knowledge of HMO, POS, PPO, EPO, IPA, Medicare Advantage, Covered California (Exchange), capitation, commercial and government...full at the me payment is due. . May review for applicable cash rates, special rates, applicable professional… more
- Northeast Georgia Health System, Inc (Oakwood, GA)
- …transmission and electronic billing systems, including reimbursement knowledge of Medicare , Blue Cross, United Health Care, Medicaid, commercial insurance and ... and Procedures as well as the NGHS handbookDemonstrate thorough understanding of Medicare and commercial waivers if pertinent to jobDemonstrate competency in use and… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …reporting for governmental entities, including, but not limited to IRS, Medicare , Medicaid, pension, state filings and involvement/approval in other reports ... of the department and conducts individual meetings with all employees in order to review , plan and coordinate activities of the specific area and recommends ways of… more
- EasternWoods Outpatient Center (Findlay, OH)
- …enters all required information, completing all necessary forms (ie Medicare Questionnaire). Obtains patient consent signatures. Reviews physician orders for ... assures that scanned images are legible and of good quality. Duty 4: Modify, Review and create new encounters ensuring the correct encounters are being used at all… more
- Senior Living Communities (North Branford, CT)
- …updates, etc. and create necessary paperwork for each Employee's status change. 14. Review and complete onboarding event tasks and follow up with candidate as ... E-verify (ongoing deadline of 3 days after hire) 15. Recruiting items - Review new applications, schedule interviews, follow up with new offers, etc. 16. Add… more
- Staffing Now (Boston, MA)
- Pharmacy Operations Specialist temporary position. Duties: Review daily reject and paid claims to ensure proper adjudication. Daily and monthly transition review ... submit and post formularies using formulary management tools. Monthly review of EOBs to ensure accuracy of information. ...related area or equivalent experience required. Experience working with Medicare Parts B and D or Medicaid Plan preferred.… more
- Fidelity TalentSource LLC (Boston, MA)
- …Health and Welfare Services, Health and Benefit Accounts, Expense Management, and Medicare Services.As an integral part of the Health Data, Analytics and Guidance ... not limited to a criminal, civil litigations and regulatory review , employment, education, and credit review (role...and regulatory review , employment, education, and credit review (role dependent). These investigations will account for 7… more
- Fidelity TalentSource LLC (Westlake, TX)
- …of solutions include health and welfare services, health and benefit accounts, and Medicare services. As we generate an abundance of data and insights, you will ... not limited to a criminal, civil litigations and regulatory review , employment, education, and credit review (role...and regulatory review , employment, education, and credit review (role dependent). These investigations will account for 7… more
- Staffing Now (Boston, MA)
- Pharmacy Operations Specialist temporary positionDuties: Review daily reject and paid claims to ensure proper adjudicationDaily and monthly transition review , ... maintain, submit and post formularies using formulary management toolsMonthly review of EOBs to ensure accuracy of informationReview pharmacy directories… more
- Blanchard Valley Health System (Findlay, OH)
- …and records to reflect the appropriate financial results of the Organization. Includes review of entries to the general ledger to assure accuracy and compliance with ... regulations and procedures. Accountable for the accurate and timely completion and review of significant balance sheet account reconciliations and audits. Duty 2:… more
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