- National Health Care Associates (Stafford Springs, CT)
- …appreciated. We invite you to join our team! **-** **What You'll Do:** As a Medicaid Specialist , you will support the center's business office in processing ... are valued and appreciated, we invite you to join our team as a Medicaid Specialist **-** **What We Offer** As an affiliate of National Health Care, our… more
- National Health Care Associates (Stafford Springs, 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
- Sumitomo Pharma (Providence, RI)
- …dynamic, highly motivated individual for the position of **Multi-Specialty Portfolio Specialist /Associate Portfolio Specialist .** This position is being posted ... Associate level role. In this field-based role, the **Multi-Specialty Portfolio Specialist /Associate Portfolio Specialist ** will focus on achieving sales goals… more
- Hartford HealthCare (Mansfield Center, 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
- Cognizant (Providence, RI)
- **Sr. Facets Dental Configuration Specialist ** **Location: Remote** **Employment Type: Full-Time** **Job ID: 00067013861** **About the role** As a Technical Analyst ... decisions and downstream impacts. + **Apply comprehensive knowledge of Medicaid , Medicare, and commercial business rules across configuration activities** .… more
- Cayuse Holdings (Providence, RI)
- **Overview** **_JOB TITLE:_** Support Services Program Manager / Specialist **_CAYUSE COMPANY:_** Cayuse Civil Services, LLC **_LOCATION_** Remote **_SALARY:_** ... by the client.** **The Work** The Support Services Program Manager/ Specialist responsible for driving technical integration projects, providing expert consultation… more
- Cardinal Health (Providence, RI)
- …+ Submitting medical documentation/billing data to Commercial (MCO) and government (Medicare/ Medicaid ) providers + Denials resolution for unpaid and rejected claims ... experience preferred + 1+ years experience as a Medical Biller or Denials Specialist preferred + Strong knowledge of Microsoft excel + Ability to work independently… more
- Highmark Health (Providence, RI)
- …medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation ... Professional Coder (CPC) + Certified Risk Coder (CRC) + Certified Coding Specialist (CCS) + Registered Health Information Technician (RHIT) **Preferred** + None… more
- Charter Care Health Partners (Providence, RI)
- …The specialist will be familiar with and understand Medicare, Medicaid , other government payers, Commercial and HMO/PPO Payers guidelines and principals. ... Education: High school graduate or GED required. Associate's level degree preferred. Experience: Prior experience working in a related role in a medical office or other health care related organization. 2-3 years of prior insurance verification and… more
- Novo Nordisk (Norwich, CT)
- …of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage Requirements, Step Therapy, ... Coverage Gap, Copays, and Deductibles and the impact on customer decisions + Demonstrates understanding of territory customer groups and affiliations such as IPAs, Medical Groups, Health Systems, and Local Clinics and uses this to identify business… more
- Cardinal Health (Providence, RI)
- …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 insurance benefit practices, preferred + Excellent written and oral communication, mediation, and… more
- Humana (Providence, RI)
- …core VB Program portfolio. + Develops new/innovative payment designs for specialist physicians and specialty organizations + Standardizes and accelerates innovative ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Evolent (Providence, RI)
- …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
