- Elderwood (Buffalo, NY)
- …Medical Billing Specialist to join our team. Medical Billing Specialist ( Medicare /Managed Care) Position Overview: + Elderwood Administrative Services is ... Life Insurance, Medical, Dental, and Vision insurance Responsibilities Medical Billing Specialist ( Medicare /Managed Care): + Review remittances for potential… more
- Wider Circle (Mcallen, TX)
- …a fast-growing boutique insurance agency focused on helping people understand their Medicare Benefits. We work with underserved populations to help them navigate ... Medicare to identify the best benefits for their needs....Ask Claire is looking for a remote telephonic Outreach Specialist to join our fast-paced team to connect with… more
- PruittHealth (Norcross, GA)
- **JOB PURPOSE:** Supports the delivery of all Medicare billing services by final/higher level auditing, correcting, and submitting claims. Ensures that billing ... productivity performance standards, are familiar with the rules and regulations of Medicare billing and are skilled at problem solving and account resolution. They… more
- Houston Methodist (Katy, TX)
- Medicare compliance experience is preferred ** **Note: Office for this position is located at our Continuing Care Hospital:** **701 S. Fry Rd. Katy, TX 77450** ... **. (Hybrid position)** At Houston Methodist, the CBO Regulatory Compliance Specialist position is responsible for working with Houston Methodist's Corporate Central… more
- ProMedica Health System (Toledo, OH)
- …billing, accounting, or business experience with and third party billing experience preferred . Medicare experience required. 3. Physical Demands: Work is ... Responsible for Daily Review of outstanding and incoming Medicare Additional Development Requests (ADRs). Responsibilities: 1. Maintains updated files as changes… more
- Wider Circle (Anaheim, CA)
- Wider Circle is looking for a Bilingual Community Health Engagement Specialist (Part-Time) in Anaheim/Gardena, CA to play a vital role in our groundbreaking program, ... first 90 days. Requirements + A genuine interest in working with Medicaid/ Medicare /DSNP populations and a commitment to building strong, supportive communities. +… more
- TEKsystems (Minneapolis, MN)
- …This is a non-IT position falling under the operations vertical. This team specifically works Medicare plans. This is a smaller team of 6 and growing to 12. These ... degree 1 year of Excel experience (No V lookups or Pivot Tables) Preferred experience: 3+ years of health care insurance experience. Knowing medical terminology,… more
- TEKsystems (Minneapolis, MN)
- …degree) + 1 year of Excel experience (No V lookups or Pivot Tables) Preferred experience: + 3+ years of health care insurance experience. + Knowing medical ... terminology, deductible, copay, provider language will help them stand apart. + Experience in a production based environment is a plus. About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new… more
- CVS Health (Richmond, VA)
- …help to support various Scorable Action Items (SAI) programs in the Medicare population, including Fraud, Waste, and Abuse (FWA), Formulary Education, Therapeutic ... for: + Performing pharmacy reviews and making evidence-based recommendations regarding Medicare members + Identifying opportunities within the health plan for… more
- CVS Health (Austin, TX)
- …for: Performing pharmacy review and making evidence-based recommendations regarding Medicare members. Identify opportunities within the health plan for integration ... programs. Communicate to providers and members on quality indicators for Medicare programs. Provide clinical pharmacy support to programs targeted toward the… more
- Commonwealth Care Alliance (Boston, MA)
- …This Role is Important to Us:** Under direction of the Director of Medicare Compliance, the primary focus areas of this position include development and oversight ... includes: Corrective Action Plan (CAP) management, regulatory reporting to Centers for Medicare & Medicaid Services (CMS), State Agencies and Department of Insurance… more
- Martin's Point Health Care (Portland, ME)
- … Medicare Specialist ) or TRICARE (for USFHP Specialist ) appeals processes and regulations strongly preferred Skills/Knowledge/Competencies (Behaviors): ... since 2015. Position Summary Job Description Position Summary: The Appeals Specialist ( Medicare or US Family Health Plan) is responsible for ensuring… more
- Medical Mutual of Ohio (OH)
- **_The Proposal Specialist position allows you the flexibility to work at home as long as you reside within a 50-mile radius an Ohio Medical Mutual office._** ... fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Medical Mutual' s… more
- InnovaCare (Ponce, PR)
- …passion and customer focus to the business. POSITION DESCRIPTION The Quality Specialist Nurse is responsible for monitoring quality of care and services delivered ... of experience in clinical nursing. Previous QA review experience preferred . GENERAL SKILLS AND KNOWLEDGE + Must have ability...management in North America. Through two it's main ways, Medicare Advantage and the provider network, we are committed… more
- Intermountain Health (Murray, UT)
- **Job Description:** The Pharmacy Government Specialist II is responsible for the day-to-day operations of Medicare Part D, providing superior customer service ... call flow as well as established auditing criteria. The Specialist II stays current and conversant on general plan...to inquiries regarding pre- and post-enrollment, benefits, cost sharing, Medicare forms, True Out Of Pocket (TrOOP) status, and… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Responsibilities** **Learning ... & Development Specialist I** Delivers, develops, and implements corporate or divisional...in a financial services environment. . Certified Professional Trainer preferred (or working towards designation). . Knowledge of and… more
- PruittHealth (Macon, GA)
- …MACON or ATHENS** **JOB PURPOSE:** The purpose of the Outreach and Enrollment Specialist role for PruittHealth Premier to serve as a licensed insurance agent to ... office space/work location is provided. The Outreach and Enrollment Specialist conducts the majority of their work within local...6. Ability to learn and carry out Centers for Medicare & Medicaid Services rules and regulations. 7. Meet… more
- MetroLink (Los Angeles, CA)
- Special Services Employee (TEMP) - Finance Specialist II (Accounts Payable) Print (https://www.governmentjobs.com/careers/scrra/jobs/newprint/4435696) Apply ... Special Services Employee (TEMP) - Finance Specialist II (Accounts Payable) Salary $1,827.77 - $2,834.85 Biweekly...(10) Health Maintenance Organization (HMO) plans and two (2) Preferred Provider Organization (PPO) plans. Some health plans are… more
- MetroLink (Los Angeles, CA)
- Contract Specialist Print (https://www.governmentjobs.com/careers/scrra/jobs/newprint/4472709) Apply Contract Specialist Salary $59,645.00 - $92,450.00 ... + Benefits + Questions SUMMARY PURPOSE OF POSITION The Contracts Specialist performs quality control checks, confirms that contract and procurement processes… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …position has the option to work hybrid; Cleveland, Ohio residents preferred ._** **Responsibilities** **Member Communications Specialist ** + **Writes and edits ... fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Develops elements of… more