- US Tech Solutions (Columbia, SC)
- …and to coordinate with team, providers, and patient representatives regarding patient care . + Skill sets/qualities: Same as required skills listed in job ... staff (Medical Director, Case Manager, Preventive Services, Subrogation, Quality of care Referrals, etc.). + Participates in data collection/input into system for… more
- Humana (Columbia, SC)
- …+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Proficient utilizing electronic medical record ... caring community and help us put health first** The UM Administration Coordinator contributes to administration of utilization management. The UM Administration … more
- Humana (Columbia, SC)
- …+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Knowledge of Medical Terminology and/or ICD-10 ... codes + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Bilingual (English & Spanish) fluent in… more
- Cardinal Health (Columbia, SC)
- …management preferred. + Familiarity with Medicare, Medicaid, commercial insurance plans, and managed care preferred. + Proficiency in billing software (eg ... Coordinator , Financial Counseling **_What Financial Assistance Counseling (RCM)...open enrollment opportunities + Initiate and track all charity care applications + Work closely with other Financial Counselors,… more
- Cardinal Health (Columbia, SC)
- …management preferred. + Familiarity with Medicare, Medicaid, commercial insurance plans, and managed care preferred. + Proficiency in billing software (eg ... building relationships of trust with customers and internal business partners. The Coordinator , Collections is responsible for the timely follow-up and resolution of… more
- Cardinal Health (Columbia, SC)
- …management preferred. + Familiarity with Medicare, Medicaid, commercial insurance plans, and managed care preferred. + Proficiency in billing software (eg ... and collect patient service revenue. The revenue cycle shadows the entire patient care journey and begins with patient appointment scheduling and ends when the… more
- Cardinal Health (Columbia, SC)
- …Minimum 2 years of experience in Insurance follow-up preferred + Understanding of managed care contracts and fee schedules, including Medicare and Medicaid ... accurately, efficiently, promptly, recognizing their importance and relationship to patient care + Consults with appeals department for disputed / denied claims.… more
- Highmark Health (Columbia, SC)
- …degree + Pharmacy technician certification certificate + Experience working in a managed care medication formulary management environment + Working knowledge of ... retail pharmacy and/or third party prescription procession + Strong background and understanding of medications and formulary terminology + Pharmacy technicians must be familiar with multiple Medicaid drug benefit design offerings and rules/regulations across… more
- CVS Health (Columbia, SC)
- …and stable health conditions. The CMS collaborates closely with the Registered Nurse Care Manager, Care Coordinator , Social Worker, and other ... the role of care management within Medicare and Medicaid managed care . + **Community Resources:** Familiarity with community resources and services. +… more
- AmeriHealth Caritas (Columbia, SC)
- …goals and resolving problems. + Coordinates care and services with the Care Coordinator , Community Health Navigator, and member, member care giver ... to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health… more
- Humana (Columbia, SC)
- …health care delivery system. + Knowledge of MCG or Interqual. + Managed care experience. **Additional Information** **Work Days/Hours** : Monday - Sunday; ... holistic approach for case management throughout the continuum of care . The case manager will offer guidance, support, and...involvement. The case manager will serve as the primary coordinator and point of contact for the beneficiary for… more