- Molina Healthcare (Worcester, MA)
- …the product choices available to them, the enrollment process (eligibility requirements, Medicare review /approval of their enrollment application, timing of ID ... for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare -Medicaid recipients within approved… more
- Robert Half Accountemps (Sacramento, CA)
- …adhere to regulatory standards. Responsibilities: * Analyze and process data entries associated with Medicare billing * Review and submit claims to Medicare ... offering a contract to hire employment opportunity for a Medicare Biller in Sacramento, California. The role is within... coverage and resolve any billing issues * Regularly review and update patient records to ensure accurate information… more
- Elderwood (Buffalo, NY)
- …Insurance, Medical, Dental, and Vision insurance Responsibilities Medical Billing Specialist ( Medicare /Managed Care): + Review remittances for potential denials, ... to providing exceptional care to our residents. Medical Billing Specialist ( Medicare /Managed Care) Position Overview: + Responsible for Managed Care and Insurance… more
- Healthfirst (NY)
- …or any related degree + Experience in the actuarial field related to Medicare (bid development/ review , analysis, reporting, risk scores) + Ability to collect, ... **Duties and Responsibilities:** + Monitor experience under Healthfirst's Medicare line of business. + Provide support for... line of business. + Provide support for annual Medicare bids for all Healthfirst's Medicare products.… more
- CommuniCare Health Services Corporate (Indianapolis, IN)
- …check forms and audit for accuracy per triple check policy prior to claims submission + Review of Medicare A, Medicare A No Pays/Benefit Exhaust, Medicare ... Medicare Biller The CommuniCare Family of Companies currently...living communities. CommuniCare Health Services is currently recruiting a Medicare Biller for our Central Billing Office in Cincinnati,… more
- Sedgwick (Naperville, IL)
- … Medicare Compliance system to determines appropriate course of action and acknowledge Medicare assignments and mail + Review and sort emails in Microsoft ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Sr Medicare Associate **PRIMARY PURPOSE** **:** To gather documentation required to complete… more
- Point32Health (Canton, MA)
- …bid filing, timely and accurate response to CMS questions that may arise during desk review , review of Medicare Plan Finder (MPF) for accuracy, etc. + ... Manager will play a key role in the document creation/ review process to ensure that all communication materials reflect...of each market. All responsibilities extend to any new Medicare markets should Point32Health choose to expand its footprint… more
- Molina Healthcare (TX)
- …**Job Summary** Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an ... integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and… more
- Guidehouse (Lewisville, TX)
- …Chris Rivera (Manager, Talent Acquisition) at ###_** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare /Medicaid + Insurance Follow-up + ... Customer Service + Billing + UB-04 & CMS 1500 + Complete all business-related requests and correspondence from patients and insurance companies. + Responsible for working on 40-70 Accounts Per Day + Complete all assigned projects in a timely manner. + Assist… more
- AdventHealth (Altamonte Springs, FL)
- …insured and, if so, gathers details (eg, insurer name, plan subscriber) . Performs Medicare compliance review on all applicable Medicare accounts in order ... patients . Verifies medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards and communicates relevant coverage/eligibility… more
- AdventHealth (Bolingbrook, IL)
- …insured and, if so, gathers details (eg, insurer name, plan subscriber) + Performs Medicare compliance review on all applicable Medicare accounts in order ... patients + Verifies medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards and communicates relevant coverage/eligibility… more
- Humana (Columbus, OH)
- …or Surgery specialties + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or ... evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides medical interpretation and determinations whether services… more
- Hackensack Meridian Health (Little Falls, NJ)
- …for coding, OASIS and Hospice, and other clinical assessment tools as needed. + Review every Medicare and Managed Medicare admission chart to determine ... in the system if inappropriate codes are identified. + Review each Hospice assessment to assure each CTI, 485...in collecting information for accurate and timely coding. + Review HIS to assure an accurate reflection of the… more
- Hackensack Meridian Health (Brick, NJ)
- …for coding, OASIS and Hospice, and other clinical assessment tools as needed. + Review every Medicare and Managed Medicare admission chart to determine ... in the system if inappropriate codes are identified. + Review each Hospice assessment to assure each CTI, 485...in collecting information for accurate and timely coding. + Review HIS to assure an accurate reflection of the… more
- Insight Global (Melville, NY)
- …training sessions and meetings Call prospective as well as existing clients to review Medicare health insurance plans Represent leading insurance carriers with ... Job Description Job Summary As an inside Medicare sales representative, you will be responsible for selling Medicare products and programs to potential and… more
- Great River Health (West Burlington, IA)
- …and progress in medical charts per defined policy and procedures.Administer required Medicare forms per Utilization Review direction. Benefits: We are excited ... and documenting communication to patients regarding level of care and Medicare compliance. The assistant also would coordinate meetings, preparing reports, and… more
- System One (Lexington, KY)
- …the institution's financial integrity and regulatory adherence. Key Responsibilities: + Medicare Qualification Review : + Evaluate clinical trials to determine ... Analysis Specialist to play a critical role in ensuring compliance with Medicare 's clinical trial policy and institutional billing practices. This position involves… more
- Health First (Palm Bay, FL)
- …and secure the required forms to meet compliance with regulatory policies. 3. Perform Medicare compliance review on all applicable Medicare accounts in order ... to determine coverage. Identify patients who may need Medicare Advance Beneficiary Notices of Noncoverage (ABNs). Issues ABN forms as needed. 4. Complete Medicare… more
- CareFirst (Baltimore, MD)
- …medical pre-authorization review , Commercial inpatient and outpatient behavioral health review , Medicare intake and medical pre-authorization review , ... Medicaid / Medicare intake, and Medicaid / Medicare medical pre-authorization review . More detail can be shared during the interview process. Plans,… more
- University of Rochester (Rochester, NY)
- …audits, and third-party payor audits.** + Coordinate responses and resolution to Medicaid and Medicare credit balances + Review all accounts on the Medicaid and ... Microsoft Word, Excel, Access, Email, Emdeon (Fidelis Medicaid Managed Care and Medicare Part B) clearinghouse software, third party claims systems (ePaces, Omnipro)… more
Related Job Searches:
Home Health Medicare Review,
Medicare,
Medicare Review Nurse,
Medicare Review Nurse RN,
Medicare Review RN,
Physician Medicare Review,
Review