- CVS Health (AL)
- …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
- NHS Management, LLC (Athens, AL)
- …experience along the way. We are in search of a qualified Finanical Specialist Assistant: To perform the successful and timely completion of assigned business and ... + Performs assigned billing functions as directed by Financial Specialist or Administrator in the completion of all routine...related tasks, including but not limited to: + Medicaid, Medicare and/or secondary billing + Assist with evaluation and… more
- Prime Therapeutics (Montgomery, AL)
- …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...meets the specialized needs of the targeted population; for Medicare , is Centers for Medicare & Medicaid… more
- Community Health Systems (Birmingham, AL)
- As a Billing Specialist at Grandview Medical Group you'll join a team and be a part of a culture that's dedicated to providing top quality care to our patients. Our ... and student loan assistance for eligible roles. **Job Summary** The Billing Specialist II is responsible for managing complex billing functions, ensuring timely and… more
- Sedgwick (Montgomery, AL)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Specialist , General Liability (Property) **PRIMARY PURPOSE** : To analyze complex or ... limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. + Reports claims to the excess carrier; responds to requests… more
- Cognizant (Montgomery, AL)
- **Provider Appeals & Grievances Specialist ** (remote) This is a remote position open to any qualified applicant that lives in the United States. **Summary:** We are ... seeking a dedicated Provider Appeals & Grievance Specialist with 1 to 2 years of experience to...provider's office) Medicaid insurance customer service or claims processing Medicaid/ Medicare Insurance Customer Service with managed care plans or… more
- CenterWell (Montgomery, AL)
- …hours of 1pm-6pm ET.** + **Available to work 1-2 holidays a year.** The **E-Referral Specialist ** is an integral part of the referral process as this role is the ... the delivery of home health services preferred + Working knowledge of Medicare enrollment and guidelines governing home health agencies preferred + Demonstrate… more
- NHS Management, LLC (Lineville, AL)
- …along the way. We are in search of a qualified Financial Specialist /Medical Billing collections to join our team of dedicated professionals. Perform and/or ... billing and collection experience with nursing home receivable which includes Medicaid and Medicare Part A & B, HMO's + Experience with Medicaid Applications +… more
- Cognizant (Montgomery, AL)
- …based on the review of clinical documentation in accordance with Medicare , Medicaid, and third-party guidelines. . Effectively document and log claims/appeals ... Reviews can be based on InterQual, Milliman Clinical Guidelines (MCG), Medicare guidelines, and health insurer specific guidelines. . Review retro-authorizations in… more
- Highmark Health (Montgomery, AL)
- …share and risk share models and will be implemented for the Organization's Medicare Advantage, Medicaid, ACA, and commercial populations with the goal of maximizing ... interpretation, and outcomes strategic plan development. + 1 year experience with Medicare STARS, Medicaid HEDIS, risk revenue value streams, and population health… more
- Northeast Alabama Regional Medical Center (Anniston, AL)
- …tool and any other approved assessment tools. Knowledge of Social Security, Medicare and Medicaid and insurance for behavioral health or experience with legal ... issues regarding guardianship, consent for psychiatric treatment, DHR and Probate Court Holds, conservatorship, and advance directives/psychiatric advance directives. Understands concepts of excellence in customer service and conducts duties in positive,… more
- CVS Health (AL)
- …records coded by internal teams prior to the submission to the Centers of Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... record documentation review, diagnosis coding, and/or auditing. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical… more
- CVS Health (AL)
- …CDQA) to ensure the ICD-10 codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... record documentation review, diagnosis coding, and/or auditing. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical… more
- Evolent (Montgomery, AL)
- …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
- Insight Global (Dothan, AL)
- …client located in Dothan, AL. In this role, the Inpatient Coding Specialist will be responsible for accurately assigning diagnostic and procedural codes to ... Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/. Skills and Requirements Certified Coding Specialist (CCS) High School Diploma Hospital Coding Experience Experience… more
- Banner Health (AL)
- …and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health ... least one of the following: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician (CCS-P), Certified… more
- Banner Health (AL)
- …and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health ... least one of the following: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician (CCS-P), Registered… more
- Humana (Montgomery, AL)
- …the team as a Senior Product Manager working anywhere in the US. As a Specialist in NBA Execution, you'll play a hands-on role in translating strategy into real-time ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more