- 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
- Sumitomo Pharma (Hartford, CT)
- …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
- Baystate Health (Springfield, MA)
- …- Midpoint - Maximum $96,137.00 - $110,510.00 - $130,728.00 **UM Regulatory Nurse Specialist - Baystate Health, Health New England** This is a **full-time remote ... . Current States Eligible MA and CT The **UM Regulatory Nurse Specialist ** is responsible for delivering medical or behavioral health utilization management (UM)… more
- Cayuse Holdings (Hartford, CT)
- **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
- Baystate Health (Springfield, MA)
- …flexibility for system updates as needed. Purpose The Business Transformation Program Specialist at Health New England (HNE) is responsible for supporting business ... and other operational efficiencies as assigned. The Business Transformation Specialist will interact with cross-functional care management platform system users,… more
- Molina Healthcare (Hartford, CT)
- …the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Facilitates comprehensive research and ... coordination of benefits (COB), subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of… more
- Humana (Hartford, CT)
- …of our caring community and help us put health first** The Nicotine Cessation Specialist (NCS) should be prepared to answer the Quit line incoming or outgoing calls ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Cardinal Health (Hartford, CT)
- …+ 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 (Hartford, CT)
- …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
- Cardinal Health (Hartford, CT)
- …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
- Molina Healthcare (Hartford, CT)
- …goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and state regulatory requirements are met for pre-pay edits and ... assisting and executing projects and tasks to ensure Centers for Medicare and Medicaid Services (CMS) and state regulatory requirements are met for pre-pay edits,… more
- Public Consulting Group (Hartford, CT)
- …sector. To learn more, visit www.publicconsultinggroup.com . Engagement Operations - Training Specialist This role is focused on supporting the training needs of our ... will demonstrate the capacity for developing training content, facilitating school-based Medicaid program concepts and being a key contributor to the development… 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
- Humana (Hartford, CT)
- …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 (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