- TEKsystems (Honolulu, HI)
- The Medicare Specialist will oversee claims processing operations, ensuring accuracy, efficiency, and compliance with regulatory requirements. This role requires ... both onshore and offshore vendor relationships and support seamless operations across Medicare , Medicaid, and commercial insurance lines of business. If you are… more
- Magellan Health Services (Honolulu, HI)
- …residential settings stratified as low complexity care management needs in Medicaid, Medicare , and Whole Health markets. Supports members enrolled in Care Management ... informal) in all aspects of the Transitions of Care Specialist role. + Remains responsible for updating self on...experience related to one of targeted member markets, including Medicare , Medicaid and Whole Health. Ability to plan and… more
- Cardinal Health (Honolulu, HI)
- …a call center or customer service environment, preferred + Clear knowledge of Medicare , Medicaid & Commercial payer policies and guidelines for coverage, preferred + ... Knowledge of Diagnostic Medical Expense and Medicare Administrative Contractor practices, preferred + Clear understanding of Medical, Supplemental, and pharmacy… more
- Queen's Health System (Honolulu, HI)
- …for one (1) year experience in professional billing. * Knowledge of Medicaid, Medicare , Third Party payer requirements, SNF/ICF, ICD-10 and DRG's. * Knowledge of ... medical terminology. * Experience and/or background to demonstrate effective written and verbal communication skills in English. * Experience with Windows applications, such as Word, Excel, etc., demonstrated proficiency in using mouse and keyboard. *… more
- Queen's Health System (Honolulu, HI)
- …in an acute care facility, demonstrating good working knowledge of Medicare , Medicaid, Third Party payor requirements. SNF/ICF, ICD-9/ICD-10 and DRG. * ... Prior experience in report preparation and analysis. * Experience to demonstrate effective written and oral communication skills and interpersonal skills. * Experience to demonstrate ability to lead/conduct meetings with other departments and staff. *… more
- Always Best Care Senior Services (Honolulu, HI)
- …and individuals in need. We are seeking an experienced Home Health Administrative Specialist to join our team. The ideal candidate will have a strong understanding ... of Medicare compliance requirements for Home Health and will help...regulations. Key Responsibilities: * Oversee and maintain compliance with Medicare guidelines for Home Health services. * Assist with… more
- CenterWell (Honolulu, HI)
- …has a strong emphasis on senior-focused primary care for members of Medicare Advantage health plans and is committed to providing personalized, high-quality primary ... Identify and act on opportunities to better manage & coordinate with high-quality specialist , hospital, and community partners to serve patient needs and deepen our… more
- Humana (Honolulu, HI)
- …consumer experiences. **Preferred Qualifications** + CHC certification or similar. + Medicare Risk Adjustment Experience. + Clinical background preferred, with Part ... B and Specialist experience a plus. + Ability to analyze large...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Evolent (Honolulu, HI)
- …Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or… more
- CenterWell (Honolulu, HI)
- …assignments. The Clinical Programs Pharmacy Technician Representative 2 Community Resource Specialist works within the Maximize Your Benefits department to assist ... government sponsored support such as Low Income Subsidy (LIS) and the Medicare Savings Program (MSP) for medication assistance. Works within defined parameters to… more
- TEKsystems (Honolulu, HI)
- …Honolulu* We are seeking a detail-oriented and experienced Medical Billing and Coding Specialist . In this role, you will play a critical part in reviewing, ... and problem-solving skills. Preferred Qualifications: + Experience working with Medicare , Medicaid, and commercial insurance claims. + Knowledge of claim… more
- Cardinal Health (Honolulu, HI)
- …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will ... regulations, or third party policy. + Updates patient files for insurance information, Medicare status, and other changes as necessary or required. + Keeps email… more
- Highmark Health (Honolulu, HI)
- …system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare ... or Outpatient): Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) + AAPC Credentials (Outpatient): Certified Professional Coder… more