- buyer (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, ... relationships with its members and providers.Position OverviewAs a Claims Adjustment Specialist I, this individual will be responsible for analyzing standard to… more
- Genmab (Berkeley Heights, NJ)
- …feel like a fit? Then we would love to have you join us!Patient Access Specialist , Call Center Operations The Patient Access Specialist will be the dedicated ... as it pertains to access and reimbursement of prescribed medications. The Patient Access Specialist will be the voice of Genmab to our customers and will maintain… more
- Novo Nordisk Inc. (Lima, OH)
- …level impact Demonstrates understanding of the local payer market including Medicare , Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage ... experience working in one or more of the following areas preferred : Pharmaceutical/Healthcare, Sales, Consulting, Customer Service or Military Intermediate computer… more
- CHINESE AMERICAN PLANNING COUNCIL (New York, NY)
- …Reporting to the Program Director, the full-time Entitlement Benefits Specialist provides comprehensive prescreening and assistance for government entitlement ... benefits and immigration benefits. The Specialist will engage in multi-faceted activities to reach communities...Help SSA Low Income Subsidy (LIS) Application, EPIC and Medicare Savings Program and any other entitlement benefits Assist… more
- Neighborhood Health Plan of Rhode Island (Smithfield, RI)
- …Category Professional / Experienced Description The Policy and Claims Research Specialist is responsible for supporting the Payment Integrity initiatives and ... and operational units to ensure timely resolution of open issues. The Specialist assumes ownership and accountability for the timely and accurate identification and… more
- Clever Care Health Plan (Huntington Beach, CA)
- …the healthcare space? We are one of Southern California's fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth. Who ... the supervision of the Vice President of Operations, the Credentialing Specialist supports all credentialing operations, including direct monitoring of the delegated… more
- RELI GROUP INC (Baltimore, MD)
- …is seeking a detail-oriented Data Analyst / Business Activity Monitoring (BAM) Specialist to support the Information Security and Privacy Services (ISPS) under the ... Privacy Support Services (MSSPSS) contract for the Centers for Medicare & Medicaid Services (CMS). This role supports Task...Integrity across the ACA and NST systems. The BAM Specialist will develop and manage dashboards, analyze usage patterns,… more
- Knox Community Hospital (Mount Vernon, OH)
- …System ( MIPS ) and alternative payment models offered by Centers for Medicare and Medicaid Services (CMS) and patient centered medical home models. Ability to ... licensed to practice nursing in the state of Ohio Bachelor's in Nursing preferred 3 years' experience in physician office setting required Experience in Risk… more
- Knox Community Hospital (Mount Vernon, OH)
- …ICD10 and CPT coding skills required. Knowledge of third party payer processes preferred and compliance regulations processes Knowledge of Medicare and Medicaid ... payers 3-5 years healthcare experience required Experience with insurance authorizations preferred KNOWLEDGE AND SKILLS Must be able to problem-solve multi-task and… more
- PharmaCord (Cincinnati, OH)
- …in healthcare administration, social science or similar related fields is strongly preferred . Minimum two years of experience in healthcare access delivery or ... management is strongly preferred . 5-10 years of experience in insurance reimbursement, patient...relevant field. Certification examples include PACS (Prior Authorization Certified Specialist ), CHES (Certified Health Education Specialist ) or… more
- PharmaCord (Jeffersonville, IN)
- …directly within physician practices or outpatient clinics billing commercial insurances, Medicare , and Medicaid preferred Bi-lingual in English and Spanish ... in the life of a Medical Billing and Coding Specialist will include the following: The responsibilities include, but...(two) 2 years' of billing and coding experience is preferred Bachelor's degree in arts and sciences, social work,… more
- Insight Global (Pleasanton, CA)
- Job Description Insight Global is seeking a Medicare Billing Specialist to join their clients team. The Medicare Billing Specialist is responsible for ... the accurate preparation, submission, and reconciliation of Medicare claims for outpatient mental health services. This role...preferred . * 2+ years of experience specifically in Medicare billing. * Knowledge of CMS 1500 claims, CPT/HCPCS… more
- HCA Healthcare (Nashville, TN)
- …HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Medicare Specialist with Parallon, you can be a part of an ... you need to succeed in our organization. We are looking for an enthusiastic Medicare Specialist to help us reach our goals. Unlock your potential! **Job… more
- Community Health Systems (La Follette, TN)
- **Job Summary** The Medicare Billing Specialist is responsible for performing timely and accurate Medicare billing activities, including claims preparation, ... are submitted in accordance with regulatory guidelines and organizational policies. The Medicare Billing Specialist supports compliance with federal and state… more
- CVS Health (FL)
- …sales talent! We have an exciting opportunity available for highly motivated individuals as Medicare Sales Specialist . The position will be a part of a ... + Proficient computer skills and knowledge of Microsoft Office ** Preferred Qualifications** + 1 to 2 years Medicare...** Preferred Qualifications** + 1 to 2 years Medicare sales experience + Medicare call center… more
- Ochsner Health (New Orleans, LA)
- …in applying and improving compliance policies, procedures and processes. Perform Medicare Coverage Analysis (MCA) for sponsored research projects. Configure studies ... change at the company's discretion. **Education** Required - Bachelor's degree. Preferred -Advanced degree in healthcare or related field. **Work Experience**… more
- Molina Healthcare (Bellevue, WA)
- …team members, and manager. Basic understanding of managed healthcare systems and Medicare . ** PREFERRED EDUCATION:** Associate's or Bachelor's Degree in Social ... Work, Human Services, or related field. ** PREFERRED EXPERIENCE:** Experience with Medicare and Medicare managed plans such as MAPD, DSNP, and MMP. To all… more
- Southeast Health (Dothan, AL)
- …Using internal and external computer systems and payer portals, work traditional Medicare and Medicare Advantage/Replacement inventory to full resolution. Job ... to obtain accurate reimbursement; + Understands the use of and navigation of Medicare 's DDE system and other governmental and commercial payer websites for claim… more
- Commonwealth Care Alliance (Boston, MA)
- …Experience (nice to have):** + Prior experience working with MassHealth and Medicare Advantage reimbursement rules is strongly preferred . **Required Knowledge, ... accurate, compliant, and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims… more
- Commonwealth Care Alliance (Boston, MA)
- …Claims Operations & Quality Assurance, the Regulatory Compliance & Audits Sr. Specialist II is responsible for ensuring CCA's operational compliance with state and ... federal healthcare regulations, particularly MassHealth (Massachusetts Medicaid) and CMS Medicare requirements. This role is housed within the Claims Operations &… more
