- The Cigna Group (Bloomfield, CT)
- Pima County based - Medicare Provider Performance Enablement (PPE) Senior Analyst provides broad support to Sr. Supervisor, Sr. Manager , Director, and Other ... interaction with PPE staff as well as other Cigna Medicare departments. Position is exposed to all aspects of...not limited to Health Services, Medical Economics, Sales and Coding in order to develop solutions for strategic business… more
- Trinity Health (Columbus, OH)
- …(https://www.mcmg.mountcarmelhealth.com/) , a college of nursing (https://www.mccn.edu) , a Medicare Advantage plan (https://www.medigold.com) , and extensive ... ! **About the job:** In accordance with the Mission and Guiding Behaviors; the Manager of Coding Operations under the direction of the Director of Coding and… more
- The Cigna Group (Bluffton, SC)
- …years of experience working with Medicare Advantage , Medicare -Medicaid. Plan (Dual-Eligible) and/or Medicaid. **Certified Coding Specialist required.** ... audit activities for the Cigna Compliance Department, with particular emphasis on Coding , Risk Adjustment and Coding Decisions. Collaborates with Cigna… more
- The Cigna Group (Maitland, FL)
- …+ All market team members contribute to the growth and profitability of the Medicare Advantage (MA) business in their market in the following aspects: + ... travel between Tampa, Orlando, Jacksonville.** **Role Summary** The Provider Performance Manager is a key member of a cross-functional, collaborative organization… more
- CareOregon (Portland, OR)
- …healthcare, claims, data management, EDI experience Preferred + Experience with Medicare Advantage risk adjustment and payment methodologies Knowledge, Skills ... Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Medicare Encounter Data Analyst Exemption Status Exempt Department Finance Manager… more
- Brockton Hospital (West Bridgewater, MA)
- …and health of our patients. Position Summary: Under the general direction of the Coding Compliance Manager the Outpatient Coding Specialist is responsible ... should be: medical professionals across many locations communicating and collaborating, taking advantage of technologies and resources to make a difference in the… more
- The Cigna Group (Denver, CO)
- …conduit to the providers and the individual that represents Cigna Medicare Advantage . The Provider Performance External Representative's responsibilities ... All market team members contribute to the growth and profitability of the Medicare Advantage business in their market in the following aspects: **Growing… more
- Conviva (Tallahassee, FL)
- …business in business, healthcare administration, or related field. + Proven experience with Medicare Advantage risk adjustment functions + Proven track record of ... and help us put health first** The Director, Medical Coding extracts clinical information from a variety of medical...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- TEKsystems (Austin, TX)
- …this coder to verify correct CPC codes are being used for patients in the Medicare community for the new telehealth annual visits that the team is expanding into. ... There will be some potential lab coding they will be exposed to as well. -...and CPT codes. - Works alongside the Revenue Cycle Manager , to review and amend denied claims to ensure… more
- Medical Mutual of Ohio (OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and individual plans. Working under ... offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Our plans… more
- The Cigna Group (Chattanooga, TN)
- …Registered Health Information Management Technician (RHIT) + 5+ years of risk adjustment coding experience, 3+ national Medicare Advantage health plan ... in Chattanooga area** **Job Summary:** This role is responsible for supporting Cigna Medicare Advantage 's Risk Adjustment program for assigned populations in an… more
- Madison Core Laboratories (Huntsville, AL)
- …at least 5 years of experience dealing with all types of payers including Medicare , Medicare Advantage , Medicaid, and Commercial medical billing. This ... for 2022-2023. We are recruiting for a Revenue Cycle Manager for our Revenue Cycle Department. FLSA: Full-Time |...in medical billing (diagnostics or ancillary services preferred) + Coding certification from AHIMA or AAPC highly preferred; CPC… more
- Sharp HealthCare (San Diego, CA)
- …Rights. More fields may be added as regulations change.In cases where Tricare or Medicare / Medicare Advantage is primary or secondary, use scripting to review ... Medicare and Medi-Cal regulations. + Knowledge of ICD-10, CPT, and/or RVS coding . + Knowledge of Medicare Important Message, Medicare Secondary Payor,… more
- Amergis (Cleveland, OH)
- …pertinent information from patient records. Must have 2 years of recent production coding experience within HCC ( Medicare Advantage or IVA) Essential ... in compliance with CMS policies and procedures and Official Coding Guidelines + Implements medical center's physician query process...as possible to the Professional + Recruiter or Operations Manager + Submits vacation or personal day requests to… more
- The Cigna Group (Bloomfield, CT)
- …Expense FP&A Senior Manager will manage projection and results analysis for core Medicare Advantage Part C medical claims expense processed and paid on a ... is expected to be the largest focus for the manager in the medium and long term. This individual...for automated workflow development, ensuring consistency in documentation and coding styles across a team to help enable portability… more
- Caris Life Sciences (Irving, TX)
- …+ Understands HIPAA and importance of privacy of patient data. + Experience working with Medicare Advantage plans is a plus + Experience with Xifin is a plus ... **Position Summary** Caris is seeking a full time Manager for our Billing Operations to oversee the...+ Understanding of CPT, ICD-10, and HCPCS coding , payor regulations, and revenue cycle management + Ability… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement and individual plans. Medical Mutual' ... cross-functional Scrum team under the direction of the IT Manager . Translates user stories and customer acceptance criteria of...self-funded group coverage, including stop loss, as well as Medicare Advantage , Medicare Supplement, and… more
- Molina Healthcare (Troy, MI)
- …related to utilization management, pharmacy, quality of care, and correct coding . * Independently delivers training and presentations to assigned providers and ... member satisfaction - CAHPS, regulatory-related, Molina Quality programs, and taking advantage of electronic solutions (EDI, EFT, EMR, Provider Portal, Provider… more
- CareOregon (Portland, OR)
- …Pharmacy Benefit Coordinator II Exemption Status: Exempt Department: Pharmacy Title of Manager : Pharmacy Medicare Manager Supervises: N/A Requisition: 24583 ... Code of Federal Regulations, Oregon Revised Statutes and Administrative Rules, HIPAA, and Medicare Advantage Manuals and related guidance + Strong ability to use… more
- Brockton Hospital (West Bridgewater, MA)
- …health of our patients. Position Summary: Under the general supervision of the Ambulatory Coding Manager , and the Senior Risk Coder, the primary function of this ... should be: medical professionals across many locations communicating and collaborating, taking advantage of technologies and resources to make a difference in the… more