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Billing Manager

Loving Care Agency, Ridgefield Park, NJ

for billing; assess and streamline processes; support, guide and develop billing staff. * Maintain accurate ... in Billing Management; with experience in Medicaid and/or Medicare billing; Home Health care experience a plus *... view details

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Case Mgr, Medicare Util

Valley Health System, Ridgewood, NJ

Interqual Criteria, Milliman and Robertson Criteria , Medicare/CMS guidelines. Special Skills: Registered Nurse. ... Expected: None Supervision Received: Supervision from the Medicare Compliance Coordinator. Working Conditions:... view details

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Health Plan Sr Architectural Specialist

CSC (atlanta), Atlanta, GA

claims, benefits set up, billing, accounts receivable. Medicare Part D or Medicare Advantage is a plus.The Health Plan Sr Architect Specialist will provide technical consulting services to clients in the discipline of system architecture... view details

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Senior Program Officer (BBCSS)

National Academies-dc, Washington, DC

programs, both public and private sector (especially Medicare), health quality and health services to synthesize and edit research findings and technical data and determine the relevance of data for purposes of study. Prepares background... view details

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RN Director Case Management / Clinical Resource Ma

FTI Consulting, Washington, DC

understanding of case management information technologies, Medicare guidelines and Medical Necessity Criteria. . ... (e.g., MIDAS, Canopy, InterQual, etc.). Knowledge of CMS Medicare guidelines and Medical Necessity Requirements. view details

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02 Chief Nursing Officer - Evergreen

Kaiser Permanente-atlanta, Oakland, CA

Knox-Keene Act, Federal HMO Act, TJC, and all applicable Medicare and Medicaid regulations.- Significant leadership experience in regulatory surveys.- Must be able to work in a Labor/Management Partnership environment.- Demonstrated... view details

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Coding Quality Manager

Caloptima, Orange, CA

including Compliance, Medical and impacted departments to guide the coding standards for the organization which ... Medicare, Medi-Cal and Commercial coding guidelines. Medicare Part C reimbursement (HCC model). Benefit... view details

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RN Director Case Management / Clinical Resource

FTI Consulting, Boston, MA

understanding of case management information technologies, Medicare guidelines and Medical Necessity Criteria. . ... (e.g., MIDAS, Canopy, InterQual, etc.). Knowledge of CMS Medicare guidelines and Medical Necessity Requirements. view details

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Oncology Nurse Case Manager (RN)

United Healthcare Services, Atlanta, GA

with information, tools and solutions, we are helping to guide them through the health care system, financing their ... (Spanish/English) skills* Experience working with Medicare recipients and the geriatric population*... view details

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Dir Claim Quality, Testing and Analytics (TRICARE)

United Healthcare Services, Richardson, TX

Healthcare Industry, Claims processing and/or encounters (Medicare, Medicaid or TED) environment is preferred* ... Finance: Oversee/guide fiscal management Finance: File insurance claims Finance: Oversee Medicare/Medicaid... view details

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Nurse Senior Professional (Medical Review)

DataStaff, Inc, NC - Raleigh

proactive data analysis efforts. Applies Medicare guidelines in addition to an advanced...experience in the analysis and processing of Medicare... view details

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Medicare Prospective Payment IT Systems Analyst - Rocky Hill, CT

UnitedHealth Group, CT - Rocky Hill

of regulatory and business requirements, specifically for Medicare and Medicaid prospective payment software solutions Preparation...cases for... view details

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Medicare Prospective Payment IT Systems Analyst - Rocky Hill, CT

UnitedHealth Group, VA - Reston

of regulatory and business requirements, specifically for Medicare and Medicaid prospective payment software solutions Preparation...cases for... view details

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Clinical Nurse Supervisor, Infusion Nurse - Home Health

Private Home Care, IL - Chicago

service includes skilled nursing visits for Medicare and Private Insurance patients and is Medicare Certified. Job Summary: Due to the growing... view details

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Senior Facility Fraud Investigator - Eden Prairie, MN

UnitedHealth Group, MN - Eden Prairie

group by and sum data. Word -Creating templates) Assets: 2 years experience using SAS Enterprise Guide and SQL writing Medicaid and/or Medicare... view details

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