• Medicare Specialist (HHS)

    Walworth County (Elkhorn, WI)
    Medicare Specialist (HHS) Print (https://www.governmentjobs.com/careers/walworthco/jobs/newprint/3201106) Apply  Medicare Specialist (HHS) Salary $18.70 ... Equal Opportunity Employer Position Summary This position is responsible for assisting Medicare beneficiaries with enrollment issues regarding Medicare Part D, … more
    Walworth County (04/12/25)
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  • Clinical Documentation Integrity Specialist

    UCLA Health (Los Angeles, CA)
    Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and ... with: + A Certified Professional Coder (CPC) certification or Certified Coding Specialist (CCS) certification, required + A Certified Risk Adjustment Coder (CRC),… more
    UCLA Health (02/19/25)
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  • Pharmacy Medicare Specialist

    Intermountain Health (Columbus, OH)
    **Job Description:** The Pharmacy Government Specialist II is responsible for the day-to-day operations of Government programs, providing superior customer service ... time, availability, and call flow as well as established auditing criteria. The Specialist II stays current and conversant on general plan design and modifications… more
    Intermountain Health (04/29/25)
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  • Sr. Program Specialist , Medicare

    Molina Healthcare (Columbus, OH)
    …the benefits, operations, communication, reporting, and data exchange of the Medicare /MMP product in support of strategic and corporate business objectives. Manage ... for all Medicare lines of business the annual Medicare and Medicare -Medicaid Plan Applications and Plan Benefit Package design, as well as provide… more
    Molina Healthcare (03/29/25)
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  • Medicare Bad Debt Specialist

    PruittHealth (Norcross, GA)
    …PURPOSE:** Compilation and verification of required third party documentation for all Medicare bad debt claims on an annual cost reporting basis. Calculation of ... allowable Medicare bad debt claims based on third party documentation...2. Validate and document each paid, adjusted, and/or denied Medicare Part A coinsurance crossover claim on each remittance… more
    PruittHealth (04/26/25)
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  • Medicare Marketing Compliance…

    Centene Corporation (Chicago, IL)
    …flexibility. **Position Purpose:** Responsible for development and production of Medicare regulatory required and benefit related materials to ensure compliance ... Federal regulations and alignment with administrative policies. Position supports Medicare Solutions portfolio nationwide with presale and member enrollment… more
    Centene Corporation (04/13/25)
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  • Sr. Medicare Marketing Compliance…

    Centene Corporation (St. Louis, MO)
    …fresh perspective on workplace flexibility. **Position Purpose:** Project Lead for Medicare regulatory required and benefit related materials to ensure compliance ... regulations and alignment with administrative policies. Position supports CNC Medicare Solutions portfolio nationwide with pre-sale and member enrollment materials.… more
    Centene Corporation (04/13/25)
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  • Senior Compliance Corrections Specialist

    Centene Corporation (Jefferson City, MO)
    …States.** **Position Purpose:** Participates in corrections process for the Medicare line of business. Responsibilities include intaking and triaging suspected ... issues of non-compliance, entry of compliance issues into GRC tool and assignment/coordination of issues to corrections team members; collaborating with compliance and business stakeholders to gather information, develop corrective action plans, identify and… more
    Centene Corporation (03/27/25)
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  • Medicare Billing and Collections…

    PruittHealth (Norcross, GA)
    …for all assigned locations. This position functions within a team environment and under general supervision. Successful individuals manage a volume of work as ... **JOB PURPOSE:** Supports the delivery of all Insurance billing services by final/higher level auditing, correcting, and submitting claims. Ensures that billing services are timely, accurate, and allow for appropriate reimbursement. Conducts all claims-related… more
    PruittHealth (04/18/25)
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  • Medicare Product Implementation…

    Healthfirst (NY)
    …+ Leads or participates in product-driven workgroups, to provide input to product designs/enhancements and implementation plans + Works with key stakeholders ... (including, but not limited to Regulatory, Claims Configuration, Provider Ops, Appeals & Grievance, Medical Management, Enrollment & Billing, Sales) to identify, scope and accurately implement new benefits, services, or other product changes, update processes… more
    Healthfirst (03/26/25)
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  • Training Coordinator

    Centers Plan for Healthy Living (Staten Island, NY)
    …irregularities; determining continuing needs for Tele-Sale Agents, Benefit Navigators and Medicare Support Specialist . + Ensure all Tele-sale Agents, Benefit ... Navigators, and Medicare Support Specialists are conducting activities that are in...+ Managed long-term care knowledge + Medicaid knowledge + Medicare knowledge SCOPE INFORMATION # Direct Reports: Director Training… more
    Centers Plan for Healthy Living (04/15/25)
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  • Remote Member Engagement Specialist

    BeneLynk (San Antonio, TX)
    …to Medicare Advantage beneficiaries enrolled in a BeneLynk contracted Medicare Advantage plan. The Member Engagement Specialist makes outbound telephone ... is in service of this one central vision. REMOTE MEMBER ENGAGEMENT SPECIALIST This position holds accountability for conducting telephonic screening services… more
    BeneLynk (04/28/25)
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  • Billing Follow Up Medicare

    Chesapeake Regional Healthcare (Chesapeake, VA)
    The Medicare Billing and Follow-up Representative are responsible for the compliant, accurate and timely billing and follow-up of all hospital Medicare and ... limited as other tasks may be assigned. + Submit Medicare / Medicare Advantage plan claims both electronic and...Licenses, Registrations Applicants must be a Certified Revenue Cycle Specialist (CRCS) upon hire or within twelve months of… more
    Chesapeake Regional Healthcare (03/28/25)
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  • Senior Director Medicare Ops

    Banner Health (AZ)
    …a direct interface with the Arizona Medicaid Agency (AHCCCS), Center of Medicare and Medicaid Services (CMS), Association for Community Affiliated Plans (ACAP), and ... Healthcare Facility Manager (CHFM); Certified Facility Manager (CFM); Certified Coding Specialist (CCS); Certified Professional Coder (CPC); JD from an American Bar… more
    Banner Health (03/16/25)
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  • Health Benefits Information Specialist

    City of New York (New York, NY)
    …outreach initiatives to educate and empower our community. The Health Benefits Information Specialist plays a key role in assisting Medicare beneficiaries by ... older adults navigate the complexities of all components of Medicare . HIICAP conducts public outreach presentations and workshops to...to join our team as a Health Benefits Information Specialist . In this role, you will be tasked to… more
    City of New York (02/12/25)
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  • MedMutual Protect - Customer Care…

    Medical Mutual of Ohio (Oklahoma City, OK)
    …and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.** **Responsibilities** **MMP ... - Associate Customer Care Specialist ** Participates in the call center training program that...self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans.… more
    Medical Mutual of Ohio (04/23/25)
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  • Medical Specialist 3, Manhattan Psychiatric…

    New York State Civil Service (New York, NY)
    NY HELP No Agency Mental Health, Office of Title Medical Specialist 3, Manhattan Psychiatric Center, P25941 Occupational Category Administrative or General ... NY Zip Code 10035 Duties Description As a Medical Specialist 3, you would serve as chief of service;...for full and unconditional participation in the Medicaid and Medicare programs.OROpen Competitive:Possession of a license to practice medicine… more
    New York State Civil Service (04/17/25)
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  • Medical Specialist 2

    New York State Civil Service (Thiells, NY)
    …Yes Agency People With Developmental Disabilities, Office for Title Medical Specialist 2 Occupational Category Health Care, Human/Social Services Salary Grade 38 ... Code 10984 Duties Description Primary Duties and ResponsibilitiesAs a Medical Specialist , you would actively participate in diagnosing and treating patients within… more
    New York State Civil Service (04/28/25)
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  • Medical Specialist 1

    New York State Civil Service (Queens Village, NY)
    …Yes Agency People With Developmental Disabilities, Office for Title Medical Specialist 1 Occupational Category Health Care, Human/Social Services Salary Grade 35 ... Code 11428 Duties Description Primary Duties and Responsibilities:As a Medical Specialist , you would actively participate in diagnosing and treating patients within… more
    New York State Civil Service (04/11/25)
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  • Sr Clinical Operations Compliance…

    Medical Mutual of Ohio (OH)
    …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Acts as a subject ... matter expert and collaborates with various internal departments to ensure that Medicare Advantage (MA) clinical programs and regulatory reporting are compliant with… more
    Medical Mutual of Ohio (04/15/25)
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