- Lundbeck (Edmond, OK)
- …dynamics, anticipate and effectively address payer access issues (IDNs, Medicare , Medicaid , Commercial) using Lundbeck resources. Pharmaceutical ... Environment/Compliance - Ability to apply knowledge of pharmaceutical and regulatory environment, including accountability and adherence to Lundbeck policies and procedures and FDA regulations regarding the promotion of pharmaceutical and medical products.… more
- Lundbeck (Raleigh, NC)
- …dynamics, anticipate and effectively address payer access issues (IDNs, Medicare , Medicaid , Commercial) using Lundbeck resources. Pharmaceutical ... Environment/Compliance - Apply knowledge of pharmaceutical and regulatory environment, including accountability and adherence to Lundbeck policies and procedures and FDA regulations regarding the promotion of pharmaceutical and medical products. REQUIRED… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …of all channels of managed care environment in the US (commercial, Medicare , Medicaid , etc.); preferredSufficient understanding of financial matters to challenge ... and pressure-test assumptions (eg pricing, GTN, etc.). preferred Trave lAbility: to travel up to 10% | Some limited travel for meetings and/or conferences.Daiichi Sankyo, Inc. is an equal opportunity/affirmative action employer. Qualified applicants will… more
- Novo Nordisk Inc. (WA)
- …to: Tax, Trade, Intellectual Property, Supply Chain, Private Health Insurance, Medicare , Medicaid , Reference Pricing, Pricing / Price Increases, Reimbursement, ... Privacy, Labor / Employment Develop NNI's policy positions, in line with Enterprise Strategy Clearly communicate with federal agencies on NNI's positions Educate and enable broader Market Access and Public Affairs Teams, Corporate Tax team, and other NNI… more
- Novo Nordisk Inc. (Traverse City, MI)
- …level impact Demonstrates understanding of the local payer market including Medicare , Commercial and Medicaid benefit designs, Payer Coverage, Prescription ... Coverage Requirements, Step Therapy, Coverage Gap, Copays, and Deductibles and the impact on customer decisions Demonstrates understanding of territory customer groups and affiliations such as IPAs, Medical Groups, Health Systems, and Local Clinics and uses… more
- Humana, Inc. (Philadelphia, PA)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... us put health first Are you passionate about the Medicare population, looking for an opportunity to work in...as well as, visiting prospects in their homes. Our Medicare Sales Field Agents sell individual health plan products… more
- The Grand at Barnwell (Valatie, NY)
- …pay accounts and Medicaid conversion billing Maintain compliance with all Medicaid , Medicare , and insurance guidelines Generate and submit reports related to ... application and recertification processes Strong knowledge of billing procedures, Medicare / Medicaid rules, and managed care guidelines Excellent communication,… more
- InterDent Service Corp (Oregon City, OR)
- …to increase patient referrals, market share and/or reimbursements. Review opportunities in Medicare Advantage plans, state Medicaid programs outside of Oregon ... of various dental benefit models (FFS, Indemnity, PPO, EPO, DHMO, Discount, Medicaid , Medicare Advantage). Ideally has at least 10 years experience in the dental… more
- Treasure State Orthotic & Prosthetic Clinic, Inc. (Billings, MT)
- …verification and preauthorization will be daily tasks. A sound foundation in Medicare / Medicaid patient benefit eligibility and coverage a must. Private health ... insurance billing experience would be beneficial. Compensation will depend on experience. Benefits include paid holidays, PTO, 401k plan and profit sharing upon meeting company requirements. Please send cover letter and resume to ###@tsopmt.com recblid… more
- UnitedHealth Group (Eden Prairie, MN)
- …in large medical group setting or Health plan 4+ years working with Medicare , Medicaid regulatory requirements with Utilization Management, Case Management or ... Clinical Product Management experience Medicare , Medicaid , and Commercial insurance experience with: NCQA, URAC, state & federal regulatory requirements… more
- Cantex Continuing Care Network (Round Rock, TX)
- …of the MDS Coordinator position is to ensure appropriate reimbursement of Medicare and/or Medicaid Patients through the Patient Assessment Instrument (RAI) ... public. Essential Functions: Maintains compliance with all State and Federal Medicaid and/or Medicare rules, regulations, and published interpretations.… more
- West Suburban Medical Center, LLC (Oak Park, IL)
- …required by MDS Maintains a current and comprehensive knowledge of MDS and Medicare / Medicaid reimbursement, serving as a resource for nursing staff and ... throughout the patient's stay for re-imbursed for the services provided. Tracks Medicare / Medicaid patients to determine continued and appropriate Medicare … more
- Prime Therapeutics LLC (Albuquerque, NM)
- …and lines of business (Employer Markets, Health Insurance Marketplace (HIM), Commercial, Medicare , and Medicaid ). This individual is the primary relationship and ... inquiries Lead retention efforts for Employer Markets, Health Insurance Marketplace, Commercial, Medicare , and Medicaid health plan clients; drive the adoption… more
- AdaptHealth LLC (Boca Raton, FL)
- …data through systems as well as system interaction General knowledge of Medicare , Medicaid , and Commercial health plan methodologies and documentation ... Insurance Guidelines, Fee Schedules, NPI (National Provider Identifier), PECOS (the Medicare Provider Enrollment, Chain, and Ownership System) and "How-To" documents… more
- Aventura Health Group (Lakewood, NJ)
- …staff. Authorization & Payer Verification Verify insurance coverage and benefits ( Medicare , Medicaid , Managed Care, Private Insurance). Collaborate with ... Nurse preferred Knowledge: Understanding of SNF level-of-care requirements. Familiarity with Medicare , Medicaid , and Managed Care guidelines. Proficiency in EMR… more
- Bertrand Chaffee Hospital (Springville, NY)
- …claims. Transmits all electronic claims. Prepares trial balance reports for inpatient, Medicare , Medicaid an other carriers. Processes denials and insurance ... claims, spanning all types of carriers to include Government, Medicare , Workers Compensation/NoFault and commercial carriers. Experience with eClinicalWorks,… more
- Conifer Health Solutions (Bardstown, KY)
- …& procedures. Secures medical necessity checks/verification in accordance to Centers for Medicare & Medicaid services, verifies insurance, benefits, coverage & ... Directives, Conditions of services, Consent for treatment, Important Message from Medicare , EMTALA, etc.). Scan Protected Health Information, create and file patient… more
- Davies (Baltimore, MD)
- …general liability claims Adherence to the requirements within Section 111 of the Medicare , Medicaid , and SCHIP Extension Act of 2007 Proficiency with Microsoft ... Office Suite Preferred College degree Familiarity with Medicare requirements Other skills and abilities Proactive, independent, and takes initiative with consistent… more
- Marquis Health Services (Trenton, NJ)
- …with audit responses and maintain regulatory compliance. *Stay updated on Medicare and Medicaid regulations. *Support MDS-related quality improvement ... long-term care *Prior MDS/RAI experience *Strong clinical assessment skills *Knowledge of Medicare / Medicaid regulations Join a team that truly values and… more
- NewGen Administrative Services (Montebello, CA)
- …accounting and EMR software Teaches eligibility for all payor types, such as Medicaid , Medicare , commercial, etc Teaches authorization process for all payors ... preferred 5-7 years experience as a supervisor Possesses knowledge and experience in Medicare , Medicaid and HMO billing Possesses skills in private collection… more
