- The Cigna Group (Bloomfield, CT)
- The Medicare Provider Directory Business Analytics Advisor focuses on the use of information and analytics to improve healthcare delivery and optimize ... consumer and provider focused business processes. This position is...analytical skills + Must have in depth knowledge of Medicare Advantage provider data in OnBase and… more
- The Cigna Group (Nashville, TN)
- **Summary** The Directory Data Steward is an Advisor level role within the Provider Data Quality & Accuracy team, responsible for maintaining data lineage, ... business rules around data elements and documentation and usage...element. The team will work with multiple stakeholders across Medicare operations, as defined by the Dedicated Medicare… more
- Medical Mutual of Ohio (OH)
- …and updates appropriately affecting the accuracy of claim payments and the provider directory . + Electronically contacts providers and/or internal departments ... appropriately affecting the accuracy of claim payments and the provider directory . + Electronically contacts providers and/or...stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide… more
- Corewell Health (Grand Rapids, MI)
- … outcomes are achieved . + Extensive and comprehensive knowledge of business processes, including but not limited to provider reimbursement methodologies, ... + Participates in committees related to the team to provide feedback and ensure that the department is represented...billing + 3 years of relevant experience working with provider reimbursement methods in Medicare /Medicaid/Commercial spaces +… more
- LA Care Health Plan (Los Angeles, CA)
- …requirements. Required : Experience in provider data regulatory reporting and provider directory management. Salary Range Disclaimer: The expected pay range ... Provider Network Account Manager III Job Category: Administrative, HR, Business Professionals Department: Provider Network Management Location: Los Angeles,… more
- LA Care Health Plan (Los Angeles, CA)
- …requirements. Required: Experience in provider data regulatory reporting and provider directory management. Salary Range Disclaimer: The expected pay range ... Provider Network Account Manager II Job Category: ...State and Federal requirements for all product lines of business (Medicaid, Medicare , and Commercial). The Account… more
- Sharp HealthCare (San Diego, CA)
- …quarterly provider directories and/or addendums for the commercial and Medicare lines of business .Creates detailed specifications and desktop procedures, as ... internal candidates, marketplace factors, other requirements for the position, and employer business practices. **What You Will Do** Under the direction of the… more
- CaroMont Health (Gastonia, NC)
- …prep solutions & other various clinical duties. Performs online test directory searches to determine specimen collection & handling requirements for infrequent/misc ... orders and ICD-10 codes (CPOE). Completes medical necessity check, contacts provider for non-covered services, and/or completes ABN according to Medicare… more
- The County of Los Angeles (Los Angeles, CA)
- …criteria, and for certification of approved hospital days reimbursable under the Medicare and MediCal programs. Essential Job Functions + Plans, develops, and ... to orient new staff to Federal laws and regulations pertaining to Medicare and Medi-Cal reimbursement. + Confers with physicians, administrative personnel, and other… more
- Corewell Health (Livonia, MI)
- …staff. Will be assigned to a variety of work area as needed to provide registration services to clinical departments and patient services. + Performs all Registrar ... Practices with patient/family. Screen outpatient visits for medical necessity. Provide cost estimates. Collect and document Advance Directive information, educating… more
- The County of Los Angeles (Los Angeles, CA)
- …other Sections. + Consultant Services: Directs a staff of consultants who provide specialized consultative services in evaluating the quality of total patient care ... enforcement actions for the Division, including processing license revocations, Medicare and Medi-Cal decertifications and criminal complaints and provides technical… more
- LA Care Health Plan (Los Angeles, CA)
- …and 278 Experience and knowledge working with FHIR standards on Patient Access API, Provider Directory API, Payer to Payer API, Pre Authorization API Experience ... Shared Services Program Manager II (ALD) Job Category: Administrative, HR, Business Professionals Department: Claims Data and Support Services Location: Los Angeles,… more
- The County of Los Angeles (Los Angeles, CA)
- …concerning program administration, ensuring compliance with Federal and State Medicare and Medicaid regulations for reimbursement claiming and maximum recovery ... Work, Sociology, Public Health, Nursing, Health Administration, Human Services, Business Administration, Public Administration, or a closely-related field from an… more
- The County of Los Angeles (Los Angeles, CA)
- …rules and regulations and result in maximum revenue collection. Prepares Medicare and Medi-Cal cost reports and State mandated disclosure reports. Analyzes ... on the application, so it is important that you provide a valid email address. Please add ###@dmh.lacounty.gov (###@dmh.lacounty.gov)...against the County of Los Angeles as the system provider for any alleged or actual infringement of any… more
- The County of Los Angeles (Los Angeles, CA)
- …spot reviews of health facilities in the district. + Processes Medicare /Medi-Cal non-renewals and decertification and handles hearings and depositions related to ... number of positions, you will not be asked to provide information about a conviction historyunless you receive a...against the County of Los Angeles as the system provider for any alleged or actual infringement of any… more