MJHS

MJHS Brooklyn, NY, USA
May 23, 2019
Full time
The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. Investigates and processes claims episodes based on claims information submitted by provider and departmental policies and procedures. Reviews, investigates and adjudicates claims for medical, facility, home health care, hospice and vision services which involve the application of contractual provisions in accordance with provider contracts, authorizations and Medicare regulations. Processes claim suspensions from the system to correct processing discrepancies and other edits by reviewing online information. Investigates, intervenes, communicates and follow-up orally or in writing with a variety of internal and external sources. Evaluates claims to ensure payments are for the services rendered. Evaluates DRG grouping and pricing information. Analyzes patient and medical information to identify COB, Workers Compensation, No-fault and Subrogation conditions and coordinates benefits with other carriers, when applicable. Processes adjustments to claims.
MJHS Brooklyn, NY, USA
May 23, 2019
Full time
The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. Investigates and processes claims episodes based on claims information submitted by provider and departmental policies and procedures. Reviews, investigates and adjudicates claims for medical, facility, home health care, hospice and vision services which involve the application of contractual provisions in accordance with provider contracts, authorizations and Medicare regulations. Processes claim suspensions from the system to correct processing discrepancies and other edits by reviewing online information. Investigates, intervenes, communicates and follow-up orally or in writing with a variety of internal and external sources. Evaluates claims to ensure payments are for the services rendered. Evaluates DRG grouping and pricing information. Analyzes patient and medical information to identify COB, Workers Compensation, No-fault and Subrogation conditions and coordinates benefits with other carriers, when applicable. Processes adjustments to claims.
MJHS New York, NY, USA
May 23, 2019
Full time
Do you have a "Hospice Heart"? If your answer is yes, then you are just the leader we are looking for. When days cannot be added to a life, we add life to remaining days. Our multidisciplinary teams offer culturally-sensitive, end-of-life and palliative care services to patients and their families at home or in assisted living communities, skilled nursing facilities and hospitals. Ask about our Sign On Bonus!!! The Hospice Care Planner Referral Manager provides direction and supervision to a team of Hospice Care Planners covering an assigned area. The manager plans, coordinates, manages and evaluates the intake coordination process to ensure his/her team is providing accurate patient information to the Access Center in a timely manner to ensure that patients who meet hospice criteria are quickly enrolled onto the MJHS program. home care, nursing, RN, homecare, nurse, home care nurse, home care RN
MJHS New York, NY, USA
May 23, 2019
Full time
Do you have a "Hospice Heart"? If your answer is yes, then you are just the nurse we are looking for. When days cannot be added to a life, we add life to remaining days. Our multidisciplinary teams offer culturally-sensitive, end-of-life and palliative care services to patients and their families at home or in assisted living communities, skilled nursing facilities and hospitals. The RN Case Manager is responsible for performing physical and psychosocial assessment on patients at the end stage of life. Develops and implements a nursing plan of care and makes recommendations for care based on patients' needs. Supervises, trains and evaluates home health aids, homemakers and personal care workers in patients' homes. Requests written orders from physicians for changes in the patient plan of care as needed. home care, nursing, RN, homecare, nurse, hospice, home care hospice, hospice nurse, hospice rn
MJHS New York, NY, USA
May 23, 2019
Full time
Do you have a "Hospice Heart"? If your answer is yes, then you are just the nurse we are looking for. When days cannot be added to a life, we add life to remaining days. Our multidisciplinary teams offer culturally-sensitive, end-of-life and palliative care services to patients and their families at home or in assisted living communities, skilled nursing facilities and hospitals. Ask About Our Sign On Bonus!!! Working at various facilities including hosptials, nursing homes and clinics throughout the Bronx and Upper Manhattan, the Hospice Care Planner is responsible for evaluating and establishing a plan of care for patients referred for Hospice services. The Planner will facilitate admission of referrals upon discharge from the hospital to a hospice home care or facility program that meets the needs of the patient and his or her family members. As a key member of the business development and marketing team, the Hospice Care Planner develops and maintains positive relationships with physicians, social workers, case managers and discharge planners in the assigned area. home care, nursing, RN, homecare, nurse, hospice, home care hospice, hospice nurse, hospice rn