- Daiichi Sankyo, Inc. (Boston, MA)
- …purpose of this role is to serve as a field-based product access specialist that provides appropriate reimbursement support to HCPs to help facilitate patient access ... the appropriate utilization of NCCN/ASCO guidelines, private payer, GPOs, Medicare and Medicaid structure, Specialty Pharmacy systems and reimbursement processes… more
- Daiichi Sankyo, Inc. (Seattle, WA)
- …purpose of this role is to serve as a field-based, product access specialist that provides appropriate reimbursement support to HCPs to help facilitate patient ... the appropriate utilization of NCCN/ASCO guidelines, private payer, GPOs, Medicare and Medicaid structure, Specialty Pharmacy systems and reimbursement processes… more
- CVS Health (Nashville, TN)
- …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...selling applicable products to existing members. + Maintaining high compliance commitment and standards with a robust knowledge with… more
- Insight Global (Thomasville, GA)
- …expert guidance and support to clients regarding their benefits options. * Ensure compliance with all relevant regulations and company policies. * Assist clients in ... life insurance license. * Proven experience as a Benefits Specialist or in a similar role. * Must have...2 AEP's * Experience working in telehealth specifically in Medicare . * Strong knowledge of health and life insurance… more
- PruittHealth (Athens, GA)
- …meeting places as needed; * Substantial sales experience; * Knowledge of Medicare /Medicaid and/or nursing community dynamics. * Demonstrate compliance with CMS ... **JOB PURPOSE:** The purpose of the Outreach and Enrollment Specialist role for PruittHealth Premier to serve as a...6. Ability to learn and carry out Centers for Medicare & Medicaid Services rules and regulations. 7. Meet… more
- Medical Mutual of Ohio (OH)
- …to work hybrid or fully remote; Ohio residents preferred._** **Responsibilities** ** Compliance & Accreditation Specialist ** + **Interprets standards and ... and communicates changes.** + **Performs other duties as assigned.** **Senior Compliance & Accreditation Specialist ** + Interprets standards and regulations… more
- Ventura County (Ventura, CA)
- …and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare , and general insurance reimbursement ... Medicare and prepares reports; + Serves as lead biller/ specialist to the department; and + Performs other related...with billing and processing claims for timely reimbursement and compliance with Medi-Cal, Medicare , and general insurance… more
- Johns Hopkins University (Baltimore, MD)
- …by ensuring compliance with government regulatory guidelines (ie Centers for Medicare & Medicaid Services- CMS conditions of payment) and CPT coding standards. + ... Sr. Billing Compliance Auditor Job Posting Title (Working Title): Compliance Education Specialist Role/Level/Range: ATP/04/PE Starting Salary Range: $72,600… more
- University of Utah (Salt Lake City, UT)
- Details **Open Date** 09/04/2024 **Requisition Number** PRN39764B **Job Title** Compliance Specialist **Working Title** Compliance Specialist **Job ... protocol billing to ensure it meets the Center for Medicare and Medicaid Services coding rules, laws, and guidelines...laws, and guidelines + Review study records to ensure compliance with system interface requirements and collaborate with Epic… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Compliance Audit Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... achieve that purpose. Job Summary The Customer Solution Center (CSC) Audit Readiness Specialist II is responsible for the execution, oversight, and monitoring of the… more
- Molina Healthcare (South Florida, FL)
- …Adjustment will receive first consideration.** **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist , Quality Interventions / QI Compliance contributes ... or more of these quality improvement functions: Quality Interventions and Quality Improvement Compliance . + Acts as a lead specialist to provide project-,… more
- Aveanna (Orange, CA)
- Operations Specialist - Medical Records & Compliance ApplyRefer a FriendBack Job Details Requisition #: 196781 Location: Orange, CA 92868 Category: ... $21.00 per hour Position Details Position Overview The Operations Specialist is responsible for providing top level customer service...orders and plan of care in order to maintain compliance Demonstrates a desire to set and meet objectives… more
- Martin's Point Health Care (Portland, ME)
- …and education + 5+ years experience in managed care plan required; knowledge of Medicare Advantage (for Medicare Specialist ) or TRICARE (for USFHP ... for USFHP and GA audits and accreditation Overall Key Outcomes: + For Medicare Focused Specialist : + Researches, processes and resolves Part C reconsiderations… more
- Molina Healthcare (Florence, KY)
- …implementation of NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Specialist , Quality Interventions/ ... of these quality improvement functions: Quality Interventions and Quality Improvement Compliance . + Implements key quality strategies, which may include initiation… more
- Medical Mutual of Ohio (OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Under general supervision, ... remote; Cleveland, Ohio area residents preferred._** **Responsibilities** **Underwriting Administration Specialist ** Based on market segment assignment: + Reviews and… more
- MetroLink (Los Angeles, CA)
- Special Services Employee (TEMP) - Finance Specialist II (Accounts Payable) Print (https://www.governmentjobs.com/careers/scrra/jobs/newprint/4620361) Apply ... Special Services Employee (TEMP) - Finance Specialist II (Accounts Payable) Salary $1,827.77 - $2,834.85 Biweekly Location California 90017, CA Job Type Temporary… more
- InnovaCare (Ponce, PR)
- …passion and customer focus to the business. POSITION DESCRIPTION The Quality Specialist Nurse is responsible for monitoring quality of care and services delivered ... Maintains a log of visits and findings by provider. Performs activities in compliance with MMM Healthcare/PMC and CMS requirements. Prepares and submits to the… more
- Tarrytown Rehabilitation & Nursing Center (Everett, MA)
- …Ensures compliance with federal and state regulations, MA Medicaid, Medicare and Managed Care payment systems. Monitors, consults, and makes effective ... CLINICAL REIMBURSEMENT SPECIALIST / MULTI FACILITY We offer competitive compensation and...and MA Medicaid payment methodology. + Extensive knowledge of Medicare reimbursement, compliance , and eligibility. Knowledge, Skills,… more
- New York State Civil Service (Thiells, NY)
- …Yes Agency People With Developmental Disabilities, Office for Title Medical Specialist 2 Occupational Category Health Care, Human/Social Services Salary Grade 38 ... on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal...in Canada AND meet the other requirements for Medical Specialist 1 or 2, you are also eligible if… more
- MetroLink (Los Angeles, CA)
- Contract Specialist Print (https://www.governmentjobs.com/careers/scrra/jobs/newprint/4472709) Apply Contract Specialist Salary $59,645.00 - $92,450.00 ... + Benefits + Questions SUMMARY PURPOSE OF POSITION The Contracts Specialist performs quality control checks, confirms that contract and procurement processes… more
