- MetroPlusHealth (New York, NY)
- …including, but not limited to, New York State Medicaid Managed Care, Medicare , Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, ... enable New Yorkers to live their healthiest life. The Medicare Sales Representative II provides greater access to health...to health insurance, by providing education and assistance to Medicare individuals. The Medicare Sales Representative II… more
- Belong Health (New York, NY)
- Hello, we're Belong. We partner with regional payers to deliver Medicare Advantage and Special Needs Plan products. With a dual focus on data-driven, proactive ... Belong has completely reimagined health insurance for seniors and other Medicare -eligible individuals who have been disregarded and deprioritized for far too… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- Ready to help us transform healthcare? Bring your true colors to blue. The Medicare Risk Adjustment Strategy Program Manager will report to the Senior Director of ... Medicare Risk Adjustment and Analytics. This role will manage...changes, market dynamic forces, and new competitive threats around Medicare revenue and risk adjustment Assess new proposals or… more
- UnitedHealth Group (Eden Prairie, MN)
- …Optum Care National Risk Adjustment Healthcare Economics team , we support Medicare Advantage Care Delivery organizations by ensuring the accuracy and reliability of ... is ideal for someone with strong SQL skills, a solid understanding of Medicare Advantage Risk Adjustment, and a passion for data driven problem-solving. You'll enjoy… more
- Marshall Dennehey (Philadelphia, PA)
- …to our corporate, insurance and individual clients, is seeking a Workers' Compensation and Medicare Attorney with one (1) to four (4) years of experience to join our ... growing Medicare Compliance group within our Workers' Compensation Department. In...will include: Consulting with employers, adjusters and attorneys on Medicare issues relative to workers' compensation cases and all… more
- Molina Healthcare (Las Vegas, NV)
- …for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare -Medicaid recipients within approved ... product features and differences. Enroll eligible individuals in Molina Medicare products accurately and thoroughly complete and submit required enrollment… more
- Avamere Health Services (Seattle, WA)
- …of skilled nursing insurance billing including but not limited to Medicare , Medicaid, private insurance, HMOs, and co-insurances. Stays current with facility ... always maintained. 2 years medical billing experience required, SNF preferred, including Medicare , Medicaid, Must have, as a minimum, three (3) years' experience in… more
- Guidehouse (San Antonio, TX)
- …days from home. Essential Job Functions Account Review Appeals & Denials Medicare /Medicaid Insurance Follow-up Customer Service Billing UB-04 & CMS 1500 Complete all ... business-related requests and correspondence from patients and insurance companies. Responsible for working on 40-70 Accounts Per Day Complete all assigned projects in a timely manner. Assist client and patients in all requested tasks. Communicate to… more
- Accident Fund Holdings, Inc. (Lansing, MI)
- …compensation files for hearing. Assist Manager with docket management and case assignment MEDICARE SPECIFIC TASKS: Manage MSAs through the Center for Medicare & ... as directed by attorney. Perform special assignments as requested by the Medicare attorneys. Retrieve and analyze information from CMS, vendors, and Workers'… more
- Integrity Marketing Group (Clearwater, FL)
- …to 30 wpm with accuracy and clarity of content. Previous health/ Medicare /prescription claims adjudication experience a plus. Must have organizational and decision ... year related experience required. Experience in medical/insurance preferred. Experience with Medicare Supplement preferred. Schedule: Monday to Friday 37 hour work… more
- Integrity Insurance and Financial Services (Frisco, TX)
- Outside Medicare Sales Exclusive General Agent for Blue Cross Blue Shield of Illinois and Texas (Frisco Market) Integrity Insurance & Financial Services Inc., 2013 ... or changes *Attend Agent meetings and sales training Qualifications for Medicare Sales Agent *Strong communication and interpersonal skills *Ability to work… more
- PIH Health (Whittier, CA)
- …Care HMO Plans. Review of Medi-Cal and Managed Care HMO secondary to Primary Medicare and or Commercial Insurances. Using PM software and tools provided to read and ... with Commercial third party and Government billing requirements. Understanding of Medicare CMS rules and regulations related to accurate claims submission. Knowledge… more
- RVO Health (Charlotte, NC)
- AT A GLANCE RVO Health is looking for a Senior Product Manager - Medicare to play a key role in shaping innovative multi-channel customer journeys and enhancing ... customer service for millions of healthcare consumers. In this role you`ll be responsible for overseeing machine learning-driven voice experiences, managing the product roadmap for contact center technology and driving continuous improvements. We are seeking a… more
- CVS Health (Miami, FL)
- …part of a growing business segment, selling our competitive portfolio of Medicare products. Upon acquisition the Field Sales Representative will own the member ... but not limited to, Microsoft Office package Preferred Qualifications Prior Medicare sales experience Bilingual Education Bachelor's Degree or equivalent work… more
- The Judge Group Inc. (Bridgeport, PA)
- …Reimbursement experience. Responsibilities Reimbursement - Acute to manage the Medicare and Medicaid fee-for-service reimbursement functions for multiple assigned ... applicable federal and state reimbursement rules and regulations and optimizes Medicare and Medicaid reimbursement through development of strategic planning and… more
- Wealthy Group of Companies LLC (Champaign, IL)
- …ensuring the integrity of the facility's Resident Assessment Instrument (RAI) and Medicare processes. This position is responsible for managing the Minimum Data Set ... (MDS) assessments, care planning, and Medicare documentation to ensure compliance with federal and state...and state regulations. The Coordinator ensures that residents receiving Medicare services qualify for coverage, that skilled nursing care… more
- Vail Health Technician Healthsource (Avon, CO)
- …plan of care, and other related tasks or requirements by payors, including Medicare , using a variety of computer-based systems. If in a procedure-based department, ... and provides feedback for departmental staff meetings. Follow the Center for Medicare & Medicare Services (CMS) requirements for checking medical necessity… more
- CGI (Fairfax, VA)
- …lead the Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) Next Generation Desktop platform initiative. The Business ... system requirements, integrations and NGD CRM development work. The Centers for Medicare & Medicaid Services (CMS) provides healthcare services to approximately 79… more
- SUNSHINE ENTERPRISE USA LLC (Orange, CA)
- …relevant experience in dealing with grievance guidelines or Medi-Cal/Medicaid or Medicare programs Job Type: Contract Duration: 6 months Position Responsibilities: ... requests from the Department of Managed Health Care (DMHC), Medicare Complaint Tracking Module (CTM) from the Centers for... Complaint Tracking Module (CTM) from the Centers for Medicare Medicaid Services (CMS), the Medicare Quality… more
- UnitedHealth Group (Eden Prairie, MN)
- …support all risk adjustment efforts across our enterprise, primarily focused on Medicare Advantage Risk Modeling. We are internal analytics partners who provide ... predictive suspecting, program evaluations, and strategic guidance related to Medicare Advantage Risk Adjustment. The role also requires the...data in a business or academic setting Exposure to Medicare Advantage data files such as MMR, MOR, and… more
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