Management (ECM) Clinical Specialist II is responsible for the management and oversight activities associated with L.A. Care... with external agencies. Excellent project management skills. Working knowledge of Medi-Cal and Medicare regulations. Preferred...
Benefits Specialist II Hiring Range $22.55 to $30.06 Pay Range $22.55 to $33.82 Hiring Incentives Sign-on bonus... Qualifications for Health Benefits Specialist II: Meets all requirements of Health Benefits Specialist I in addition to the following...
in the Medicare FISS system requiring in depth knowledge of Medicare billing and compliance regulations. 10. Correct... are essential job functions. II. Position Qualifications: License/Certification/Education: Required: 1. A minimum of a High...
Specialist clinician low risk review meetings, Risk Adjustment/HCC meetings, and/or Medical Group Compliance reviews/meetings... to that specialty and how coding, documentation, and billing are affected. Maintains expert knowledge of Medicare, Medicaid...
Physician/APC education that include coding and/or documentation topics, such as Documentation Specialist clinician low risk... and how coding, documentation, and billing are affected. Maintains expert knowledge of Medicare, Medicaid, and other regulatory...
Quality & Safety department leadership, the Quality & Safety Specialist is responsible and accountable for facilitating..., but not limited to, Centers for Medicare Services (CMS) and QualityNet, Vizient, Agency for Healthcare Quality (AHRQ), LeapFrog...
. Under the direction of the Quality & Safety department leadership, the Quality & Safety Specialist is responsible... measures including, but not limited to, Centers for Medicare Services (CMS) and QualityNet, Vizient, Agency for Healthcare...
& Safety Specialist is responsible and accountable for facilitating improvements in clinical and operational performance... for Medicare Services (CMS) and QualityNet, Vizient, Agency for Healthcare Quality (AHRQ), LeapFrog, US News & World Report...
Specialist 2 investigates and evaluates patient account information, medical records and bills, billing and reimbursement... of regulations and practices used in all types of reimbursement specialties such as Government, Commercial, Medicare, Medicaid...
department leadership, the Quality & Safety Specialist is responsible and accountable for facilitating improvements in clinical... to, Centers for Medicare Services (CMS) and QualityNet, Vizient, Agency for Healthcare Quality (AHRQ), LeapFrog, US News & World...
& Safety Specialist is responsible and accountable for facilitating improvements in clinical and operational performance... for Medicare Services (CMS) and QualityNet, Vizient, Agency for Healthcare Quality (AHRQ), LeapFrog, US News & World Report...
of experience as a Provider Credentialing & Data Specialist or equivalent experience in health plan, medical office, hospital... insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual...
Commission, Centers for Medicare and Medicaid Services (CMS) and Michigan Department of Public Health (MDPH). All other duties...
, standards and laws such as but not limited to Joint Commission, Centers for Medicare and Medicaid Services (CMS) and Michigan...
; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans...
-coverage to patients (ex: HINN, ABN, waiver, Medicare lifetime reserve days). Follow up with payers on active authorized...
-coverage to patients (ex: HINN, ABN, waiver, Medicare lifetime reserve days). Follow up with payers on active authorized...
. EXPERIENCE: Two years of experience preferred in any of the following: Medicare, Medicaid and/or Commercial Insurance billing...
for assistance. Prepare and communicate/deliver notices of non-coverage to patients (ex: HINN, ABN, waiver, Medicare lifetime...
, and codes diagnostic and procedural information that determines Medicare, Medicaid and private insurance payments. The incumbent... Coding as set forth by AHIMA and adheres to Official Coding Guidelines. 9. Abides by rules and regulation of Medicare...