but not limited to external regulatory agencies such as Quality Improvement Organizations (QIOs), the Centers for Medicare & Medicaid... Services (CMS), Medicare National Correct Coding Initiative edits and other payers. Partners with Coding, CDI, CMD...
) 2+ years of practical experience with interpreting reimbursement policies and provisions for Medicare, Community... experience Knowledge of Medicare reimbursement methodologies, i.e., Resource Based Relative Value System (RBRVS) Knowledge...
with applicable regulatory, legal, and policy requirements. This role partners with other areas of the Office of Information Security... Security (except Medicare). Instead, you’ll choose between state pension plans (OPERS, STRS) or an Alternative Retirement Plan...
with applicable regulatory, legal, and policy requirements. This role partners with other areas of the Office of Information Security... Security (except Medicare). Instead, you'll choose between state pension plans (OPERS, STRS) or an Alternative Retirement Plan...
with regulatory research and issue advocacy in relation to Mental Health Parity policy positioning. Guide special projects... documentation and policy positioning and advocacy. Assists in supporting successful relationship with regulatory agencies...
and implement targeted compliance training Develop and own controls related to Medicare, OFAC, Child Support Lien Network... a plus but not required Deep understanding of claims handling regulations, Medicare protocols, and market conduct standards Experience...
a plus Experience with multiple lines of business in a 50-state claims environment Knowledge of Medicare Secondary Payer requirements... and Section 111 reporting Strong research and policy writing skills Excellent collaboration, project management, and problem...
, Connecticut. The Plan Sponsor Liaison [PSL] will serve as the Single Point of Contact for Aetna Medicare Advantage servicing... as primary liaison between Plan Sponsors, their TPA's, Brokers, Consultants, Aetna Medicare Account Management Team, Aetna...
features Medicare and Medicaid content coupled with flexible contract configuration capabilities for Commercial lines...’s degree. Minimum of 3 years of experience in healthcare payment integrity, content & policy, contracts, claims processing...
features Medicare and Medicaid content coupled with flexible contract configuration capabilities for Commercial lines...’s degree. Minimum of 3 years of experience in healthcare payment integrity, content & policy, contracts, claims processing...
requests for information required by the organization for its Duals and SMAC regulatory filings. Manages Duals (and Medicare... and create policy and/or position statements. Partners with leadership to manage annual SMAC assessment and tracking of caps...
documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group (APR-DRG..., physicians, and other contacts. Must consistently demonstrate the ability to understand the Medicare Prospective Payment System...
on policy changes to government payor programs. Working with the Manager of Reimbursement, advocates for administrative... information required for the completion of the annual Medicare and Medicaid interim and year-end cost reports. Supports...
department Implements all aspects of system requirements, including systems analysis, policy and procedure documentation... Monitors specimen tracking capabilities from collection through disposal, automated medical necessity checking for Medicare...
Security (except Medicare). Instead, you’ll choose between state pension plans (OPERS, STRS) or an Alternative Retirement Plan... balance with a generous time-off policy, including: Vacation and sick time 11 paid holidays and additional end-of-year...
As a UC employee, you won't contribute to Social Security (except Medicare). Instead, you'll choose between state pension.... Real Work-Life Balance UC prioritizes work-life balance with a generous time-off policy, including: Vacation and sick...
to Social Security (except Medicare). Instead, you’ll choose between state pension plans (OPERS, STRS) or an Alternative... work-life balance with a generous time-off policy, including: Vacation and sick time 11 paid holidays and additional...
, Access, and Teams, to drive data analysis, reporting, and workflow efficiency. Leverage experience working with Medicare.... This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination...
; Experience handling a large load of work in a fast-paced environment. Insurance, Medicare/Client knowledge Writing Letters..., pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. This policy applies...
. Conditions of Employment: Full Background: CBI name check and fingerprint check, ICON Colorado court database, Medicare fraud... Analyst will review the work experience/job duties sections of the online job application to determine whether your experience...