- 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
- 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
- Accessia Health (Midlothian, VA)
- POSITION TITLE : Case Management Specialist REPORTS TO : Patient Services Supervisor POSITIONS MANAGED : None STATUS : Non-Exempt SUMMARY: The Case Management ... Specialist is responsible for acting as a bridge between...In-depth knowledge of private and public health insurance plans ( Medicare , Medicaid, COBRA, Marketplace) and related terminology. Ability to… 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
- Sprenger Wellspring Silver Maple (Lorain, OH)
- …experience in Insurance Billing field. Essential Job Functions: Responsible for Medicare , managed care, Mycare, and ancillary billing. Monthly review of outstanding ... balances. Responsible for appeals. Assists with insurance verifications when needed. The position offers a competitive wage based on experience, and many other benefits including: Health insurance with company paid life insurance Dental, Vision and Voluntary… 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 ... collect, analyze, and report data and other pertinent information Ability to identify opportunities for improvement through analysis of data Proficient in Microsoft Office Suite programs. Ability to retrieve and analyze clinical data to identify problem areas.… 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
- Knox Community Hospital (Mount Vernon, OH)
- …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 work independently Must have outstanding customer service and telephone communication skills Must be able to adjust to change Must be PC literate with… 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
- PharmaCord (Cincinnati, OH)
- …in relevant field. Certification examples include PACS (Prior Authorization Certified Specialist ), CHES (Certified Health Education Specialist ) or CCM in ... issue resolution. Knowledge of healthcare compliance regulations, including HIPAA and Medicare /Medicaid guidelines. Bi-lingual skills are a plus. We are located in… more
- PharmaCord (Jeffersonville, IN)
- …A typical day in the life of a Medical Billing and Coding Specialist will include the following: The responsibilities include, but are not limited to ... directly within physician practices or outpatient clinics billing commercial insurances, Medicare , and Medicaid preferred Bi-lingual in English and Spanish or… more
- The Career Sphere (NC)
- …patient panel is a 60:40 pediatric to adult mixture with less than 150 Medicare patients. Must be comfortable seeing patients a day 36hour clinic weeks 100% ... Onsite Lab and affiliated urgent care with radiologic services Local specialist support from: ENT, Ortho, General Surgery, Derm, OBGYN, Hematology/Oncology, Urology,… 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 ensures compliance with Medicare … 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 ... specialized team who will focus on educating existing Medicare members on available plan offerings to help meet...Work defined campaigns that are designed to assist Aetna Medicare members holistically find the appropriate Aetna Medicare… 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
- Southeast Health (Dothan, AL)
- …Summary Job Description Shift DayShift Details FTE 1 Type Regular Join one of Forbes 500 best mid-sized employers in America. Equal Employment Employer Southeast ... Health is committed to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or… more
- Molina Healthcare (Bellevue, WA)
- …of Member Materials. **Knowledge/Skills/Abilities** + Conducts direct outreach to new Medicare members to provide personal assistance with their new MAPD, DSNP, ... database. + Participate in Member engagement work groups as needed to ensure Medicare member needs are being anticipated and addressed. + Participates in regular… 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
- Staffing Solutions Organization (Albany, NY)
- …a reflection of our clients and the people they serve. **Senior Healthcare Program Specialist (Level 2 or 3) - Albany, NY** **Division of Eligibility & Marketplace ... Integration (DEMI)** **Bureau of Third-Party Health Insurance, Medicare Savings Program and Recoveries** **Telecommuting Option:** This position is eligible for… more
