- National Health Care Associates (Wethersfield, CT)
- …Direct care in a long-term care setting, MDS Coordinator, Clinical Reimbursement Specialist or Nurse Assessment Coordinator experience preferred + Knowledge of state ... federal regulations governing the MDS, Electronic Medical Record (EMR), PDP, MDS 3.0, Medicaid and Medicare requirements helpful + Interest in the nursing needs of… more
- National Health Care Associates (Stafford Springs, CT)
- …you to join our team! **-** **What You'll Do:** As an Accounts Receivable Specialist , you will generate and process invoices accurately and in a timely fashion. Your ... you to join our team as an Account Receivable Specialist **-** **What We Offer** As an affiliate of...**-** **What You'll Bring:** **Qualifications of an Accounts Receivable Specialist include:** + Previous A/R experience in a Long-Term… more
- Hartford HealthCare (Torrington, CT)
- …become part of Connecticut's most comprehensive healthcare network as a Pre-Billing Specialist . The Pre-Billing Specialist is responsible for reviewing and ... system prior to claim submission. This role ensures compliance with Medicare, Medicaid , and other Commercial payer requirements, helping to prevent billing errors… more
- Hartford HealthCare (Hartford, CT)
- …with Spanish being their primary language, and have healthcare coverage under Medicaid . Our specialists are skilled at treating many infectious conditions, including ... as well as a Travel Clinic. *Job Summary:* The Tobacco Treatment Specialist provides behavioral counseling to help current smokers and/or vapers quit. Working… more
- Hartford HealthCare (Farmington, CT)
- …other common practices across the system.*__* *_Position Summary:_* The Audit Specialist is responsible for reviewing clinical documentation to determine appropriate ... Researches literature from regulatory groups such as; HHS/OIG, Medicare, Medicaid , NGS, etc., professional and peer organizations' practices/policies/guidelines to… more
- Prime Therapeutics (Hartford, CT)
- …every decision we make. **Job Posting Title** Medication Therapy Management Specialist **Job Description** The Medication Therapy Management (MTM) Service ... Specialist is responsible for receiving inbound and making outbound...targeted population; for Medicare, is Centers for Medicare & Medicaid Services (CMS) compliance compliant + Utilize Prime's MTM… more
- Wheeler Clinic (Bristol, CT)
- …growth at all stages of life. POSITION SUMMARY The Family Support Specialist provides direct services/case management/coordination of care to an assigned caseload of ... records in accordance with documentation timelines and in compliance with Medicaid , licensing and other regulatory requirements/agencies as defined by program.… more
- Molina Healthcare (Springfield, MA)
- …and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution ... of the appeals from Molina members, providers and related outside agencies to ensure that internal and/or regulatory timelines are met. + Research claims appeals using support systems to determine Medicare appeal and claim outcomes. + Requests and reviews… more
- Humana (Hartford, CT)
- …well as modeling financial impact of emerging therapeutics across Medicare and Medicaid LOBs + Researches and analyzes drugs and emerging therapeutics, including ... residency or similar pharmacy practice experience + Board Certified Pharmacotherapy Specialist (BCPS) + MBA, pharmacoeconomics or health outcomes training + An… more
- Hartford HealthCare (Farmington, CT)
- …a multi-entity hospital and professional office environment, the Financial Counseling Specialist is responsible for analysis, investigation and resolution of patient ... and transfers. 3. Performs pre bad debt screening (reviews accounts for Medicaid Eligibility and/or bad debt vs. charity care). 4. Updates insurance information… more
- Prime Therapeutics (Hartford, CT)
- …The Sr Health Plan Account Manager serves as a line of business specialist for their assigned account/s and provides information, analyses, and consulting to the ... in the market. **Responsibilities** * Serve as a line of business specialist responsible for managing client relationships within assigned health plan/s; effectively… more
- Cardinal Health (Hartford, CT)
- …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will ... with secondary insurance company when necessary. + Bills supplemental insurances including all Medicaid states on paper and online. + Mails all paper claims. + Acts… more
- Hartford HealthCare (Farmington, CT)
- …Up/Denials Supervisor, in the day-to-day operations of the AR Follow Up & Denials Specialist Level 1, Level 2 and Level 3. Daily Operations consist of monitoring ... of accounts receivables engagements with small balance, out of state Medicaid and credit vendors as needed.** *_Requirements and Specifications:_* **Education** .… more
- CVS Health (Hartford, CT)
- …within budgeted costs. **What you will do** + Acts as a top-level specialist on project management and develops a comprehensive plan that encompasses objectives, ... + 7-10 years work experience in healthcare + Medicare and/or Medicare- Medicaid Integrated Product Experience + Experience with Part D Coverage Determination,… more
- Evolent (Hartford, CT)
- …Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the ... or sanction by any state or federal health care program, including Medicare or Medicaid , and is not identified as an "excluded person" by the Office of Inspector… more
