- iCare Health Solutions Enterprise (Miami, FL)
- …and reconciliation logs Stay current on industry trends in managed care contracting and reimbursement methodologies Requirements Job Specifications Typically ... NextGen Contract Utility, supporting both traditional fee-for-service (FFS) reimbursement and managed care models, including capitated, global payment, and… more
- Vinfen (Allston, MA)
- …and other care needs and goals Obtain required Prior Authorization from Managed Care Plan (ACOs, MCOs) for relevant and necessary services. Perform other ... Team. Coordinate the development, implementation, and ongoing review of the care plan. Conduct medication reviews and reconciliation including adjustment by… more
- AdventHealth (Maitland, FL)
- …Provides guidance and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract terms and policies including; governmental ... strong working relationship with AdventHealth Florida and Multi-state Division leadership, Managed Care Reimbursement team, Regional Revenue Cycle leadership,… more
- Penn Medicine (West Windsor, NJ)
- …cards. Update/ enter e-MDs demographic information. + Collect appropriate co-payments for managed care members, post payment and issue receipt. + Collect ... or requests. Obtain necessary signed release from patient. + Maintain knowledge of managed care and third party billing requirements relative to front desk… more
- Mount Sinai Health System (New York, NY)
- …and/or Health Plan auditing setting, or within a hospital?s Delegated Enrollment or Managed Care Enrollment Department + Knowledge of NCQA standards (Joint ... **Job Description** **Remote Medical Staff Services Health Care Specialist (Delegation/Enrollment)** The Medical Staff Services Health Care Specialist is… more
- National Health Care Associates (Utica, NY)
- …responsibilities + Thorough knowledge of Medicare, Medicaid, Pending, Applied Income, and Managed Care reimbursement regulations + Ability to manage multiple ... at Utica is a proud affiliate of National Health Care Associates. As a Certified Great Place to Work,...compliance of the resident fund ledgers + Perform month-end reconciliation of census, revenue and accounts receivable If you… more
- Virtua Health (Moorestown, NJ)
- …in billing and health insurance guidelines and practices, including commercial, Medicare and managed care payers. Solid knowledge of and ability to use, ... the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists, life-changing … more
- Penn Medicine (Cherry Hill, NJ)
- …pertinent to patient service and billing procedures: including basic knowledge of all managed care plans and which insurers require a copayment or referral. ... is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field… more
- Penn Medicine (Monroe, NJ)
- …updated on EMR and checked in on a timely manner. + Maintain knowledge of managed care and third party billing requirements relative to front desk processes, ... cards. Update/ enter e-MDs demographic information. + Collect appropriate co-payments for managed care members, post payment and issue receipt. + Collect… more
- Mount Sinai Health System (New York, NY)
- …+ Opportunity to work at the forefront of innovation in healthcare The Managed Care Contracting Team within MSHP is responsible for the negotiation, ... compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's subject matter experts… more
- Penn Medicine (Cherry Hill, NJ)
- …pertinent to patient service and billing procedures: including basic knowledge of all managed care plans UPHS participates with and which insurers require a ... is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field… more
- Penn Medicine (Cherry Hill, NJ)
- …pertinent to patient service and billing procedures: including basic knowledge of all managed care plans UPHS participates with and which insurers require a ... is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field… more
- Penn Medicine (Cranbury, NJ)
- …cards. Update/ enter e-MDs demographic information. + Collect appropriate co-payments for managed care members, post payment and issue receipt. + Collect ... + Scan medical records and correspondence as needed. + Maintain knowledge of managed care and third-party billing requirements relative to front desk processes,… more
- Northwell Health (Staten Island, NY)
- …questionnaire. + * Completes, reviews, updates and replenishes Medicaid and Medicaid Managed Care transportation fund. Disperses Medicaid and Medicaid Managed ... information on the admitting board. + * Completes daily reconciliation of all patients. Reviews and updates daily census...required. *Additional Salary Detail The salary range and/or hourly rate listed is a good faith determination of potential… more
- Aspen Dental (Albany, NY)
- …across the organization. This role will play a key part in supporting our managed care operations and strategic payor initiatives. The Director will ensure data ... BigQuery for data extraction, transformation, and analysis. + Deep understanding of managed care operations, including provider and facility data structures and… more
- Morehouse School Of Medicine (Atlanta, GA)
- …of the health professional and scientific workforce; * Address primary health care through programs in education, research and service; With emphasis on people ... Monitors expenses, tracks balance, conducts variance analysis, and projects burn rate and future utilization. + Oversees all grants management activities, such… more
- Ventura County (Ventura, CA)
- …Increase your spending power by reimbursement with pre-taxed dollars for IRS-approved dependent care and health care expenses. + Holidays: 12 paid days per ... and time-sensitive financial duties involving budget, cost accounting, projections, rate development, grant reimbursement requests, and financial reporting. This… more
- Elderwood (Fairport, NY)
- …oversees key business office functions, including maintaining accurate census and rate information in PCC, managing resident trust account transactions and ... follows up on Medicaid pending cases. This role also collaborates with the Care Coordinator to maintain accurate level-of- care documentation. This is an… more
- Veterans Affairs, Veterans Health Administration (Iron Mountain, MI)
- …medication review for polypharmacy, recent hospital or emergency department discharges, and co- managed care patients. 7) Follows up via face-to-face, telehealth, ... accurate, up-to-date, relevant drug information and drug literature analysis to health care professionals and acts as a therapeutic consultant on matters of a… more
- Catholic Health Services (Rockville Centre, NY)
- …in internal workflow to improve patient health outcomes. Comprehends transition of care and medication reconciliation . Assists providers and quality team in ... Our health system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service,...across the continuum to ensure that patients are effectively managed and their healthcare needs are met. Utilizes information… more
