- Novo Nordisk Inc. (New York, NY)
- …level impact Demonstrates understanding of the local payer market including Medicare , Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage ... in this job family are as follows: Cardiometabolic Care Specialist I - $86,000 to $106,000 Cardiometabolic Care ...Specialist I - $86,000 to $106,000 Cardiometabolic Care Specialist II - $113,000 to $138,000 Senior Cardiometabolic Care… more
- Merck & Co. (North Wales, PA)
- Job DescriptionThe Central Contract Services (CCS) Senior Specialist will function as a vital member of the broader Integrated Account Management team focusing on ... teams to develop, implement, and execute contract strategies. The CCS Senior Specialist will also be responsible for driving continuous improvement of these core… more
- Novo Nordisk Inc. (Salinas, CA)
- …level impact Demonstrates understanding 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… more
- VNS Health (Brooklyn, NY)
- …findings and. Determines when further evaluation by collaborating physician, specialist or emergency care is warranted. Collaborates with patients, families, ... Home and associated managed care plans required Maintains NPI, Medicaid and Medicare provider numbers preferred Maintains a collaborative practice agreement with a… more
- Insight Global (Pleasanton, CA)
- Job Description Insight Global is seeking a Medicare Billing Specialist to join their clients team. The Medicare Billing Specialist is responsible for ... the accurate preparation, submission, and reconciliation of Medicare claims for outpatient mental health services. This role ensures compliance with Medicare … more
- Community Health Systems (La Follette, TN)
- **Job Summary** The Medicare Billing Specialist is responsible for performing timely and accurate Medicare billing activities, including claims preparation, ... are submitted in accordance with regulatory guidelines and organizational policies. The Medicare Billing Specialist supports compliance with federal and state… more
- CVS Health (Pierre, SD)
- …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
- University of Washington (Seattle, WA)
- …Practice Plan Services (FPPS)** has an outstanding opportunity for an **Insurance Follow-Up Specialist ** to join our ** Medicare ** team **.** **WORK SCHEDULE** + ... + Mondays - Fridays + 100% Remote **POSITION HIGHLIGHTS** The **Insurance Follow-Up Specialist , Medicare ** is responsible for the optimal payment of claims from… 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
- Molina Healthcare (Warren, MI)
- …of Member Materials. **Knowledge/Skills/Abilities** + Conducts direct outreach to new Medicare members to provide personal assistance with their new MAPD, DSNP, ... database. + Participate in Member engagement work groups as needed to ensure Medicare member needs are being anticipated and addressed. + Participates in regular… more
- Centene Corporation (New York, NY)
- …auditing, project management, or business analysis experience, preferably within the Medicare field. Previous experience coordinating cross functional teams on large ... scale projects. Ability to evaluate, understand, and communicate regulatory and business requirements. Demonstrated understanding of relationships and dependencies between functional areas. This position is remote within the state of New York. Candidates must… more
- Commonwealth Care Alliance (Boston, MA)
- …This role will ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for ... as necessary on all new and revised coding logic, related Medicare /Medicaid policies for review/approval through the Payment Integrity governance process.… more
- Commonwealth Care Alliance (Boston, MA)
- …accurate, compliant, and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims ... Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare , and commercial payment methodologies and supports audit, compliance, and provider… more
- PruittHealth (Norcross, GA)
- …for all assigned locations. This position functions within a team environment and under general supervision. Successful individuals manage a volume of work as ... **JOB PURPOSE:** Supports the delivery of all Insurance billing services by final/higher level auditing, correcting, and submitting claims. Ensures that billing services are timely, accurate, and allow for appropriate reimbursement. Conducts all claims-related… more
- Molina Healthcare (Oshkosh, WI)
- …for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare -Medicaid recipients within approved ... product features and differences. + Enroll eligible individuals in Molina Medicare products accurately and thoroughly complete and submit required enrollment… more
- Ochsner Health (New Orleans, LA)
- …in applying and improving compliance policies, procedures and processes. Perform Medicare Coverage Analysis (MCA) for sponsored research projects. Configure studies ... Research Compliance (CHRC), Certified Professional Coder (CPC), Certified Coding Specialist (CCS) or related certification. **Knowledge Skills and Abilities (KSAs)**… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …irregularities; determining continuing needs for Tele-Sale Agents, Benefit Navigators and Medicare Support Specialist . + Ensure all Tele-sale Agents, Benefit ... Navigators, and Medicare Support Specialists are conducting activities that are in...+ Managed long-term care knowledge + Medicaid knowledge + Medicare knowledge SCOPE INFORMATION # Direct Reports: Director Training… more
- SUNY Upstate Medical University (Syracuse, NY)
- …Syracuse Inc. (UUMAS) is seeking a Registered Nurse (RN), or Certified Nurse Specialist (CNS), to coordinate and conduct Medicare Annual Wellness Visits (AWVs) ... Primary Care clinic Medical Directors and Nurse Leadership. Duties/Responsibilities: Identify Medicare patients overdue for their Medicare Annual Wellness Visit… more
- Ventura County (Ventura, CA)
- …for Medi-Cal and/or Medicare and prepares reports; + Serves as lead biller/ specialist to the department; and + Performs other related duties as required. Medical ... Medical Billing Specialist III/IV - Behavioral Health Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5037514) Apply Medical Billing … more
