- Elderwood (Buffalo, NY)
- …our commitment to providing exceptional care to our residents. Medical Billing Specialist ( Medicare /Managed Care) Position Overview: + Responsible for Managed ... Life Insurance, Medical, Dental, and Vision insurance Responsibilities Medical Billing Specialist ( Medicare /Managed Care): + Review remittances for potential… 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...understanding of products, services, and processes offered by the company . + Expert level of MAPD/DSNP product offerings Ability… more
- Medical Mutual of Ohio (OH)
- …substance abuse and nicotine testing._ **Title:** _Clinical Services Support Specialist ( Medicare UM)_ **Location:** _Ohio_ **Requisition ID:** _2400556_ ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans....and Compensation: + Employee bonus program. + 401(k) with company match up to 4% and an additional … more
- VNS Health (Manhattan, NY)
- OverviewThe Medicare Enrollment Specialist educates consumers who...at 30 days of paid time off and 9 company holidays + Health insurance plan for you and ... who contact VNS Health Plans via website about VNS Health Plans Medicare products. Qualifications Licenses and Certifications: + NYS Health Insurance License,… more
- CVS Health (Monroeville, PA)
- …also provides free parking. **What you will do** + Timely response to Medicare audits and appeals + Research and gather the appropriate documentation to form ... all levels of appeals for Medicare + Third party follow-up associated with the dispensing...both verbally and written + Certified Billing and Coding Specialist (CBCS) preferred but not required . **Education** +… more
- Point32Health (Canton, MA)
- …business performance needs of each market. All responsibilities extend to any new Medicare markets should Point32Health choose to expand its footprint in the future. ... questions that may arise during desk review, review of Medicare Plan Finder (MPF) for accuracy, etc. + Support...business functions, etc. + Oversee or collaborate with Product Specialist to manage Benefit Adjudication Committee meetings and other… more
- UCLA Health (Los Angeles, CA)
- …can do all this and more at UCLA Health. As member of the Medicare Advantage Risk Adjustment leadership team, the Assistant Director of Risk Adjustment is ... presentations to leadership as needed + Train and develops performance improvement specialist + Develop policies and procedures with leadership surrounding mock RADV… 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' s ... status as a mutual company means we are owned by our policyholders, not...best possible health and quality of life. Payment Control Specialist I Processes routine corporate cash receipts and adjustments.… more
- Medical Mutual of Ohio (Brooklyn, OH)
- **_The Sourcing Specialist is a hybrid position that allows you the flexibility to work onsite 3 days a week and work at home 2 days a week as long as you reside ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans....individual plans. Medical Mutual' s status as a mutual company means we are owned by our policyholders, not… more
- Medical Mutual of Ohio (Toledo, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Medical Mutual' s ... status as a mutual company means we are owned by our policyholders, not...to a variety of member inquiries from commercial and Medicare Advantage product lines through determined channels such as… more
- Medical Mutual of Ohio (OH)
- …Medicare Supplement, and individual plans. **Responsibilities** **Business Systems Specialist I** Works with management, external vendors, and Information Systems ... staff. . Performs other duties as assigned. **Business Systems Specialist II** Works with management, external vendors, and Information...and Compensation: + Employee bonus program. + 401(k) with company match up to 4% and an additional … 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 direct supervision, ... remote; Ohio residents preferred._** **Responsibilities** **Provider Credentialing & Data Specialist I** + Categorizes returned mail and determines action needed… 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. Medical Mutual' s ... status as a mutual company means we are owned by our policyholders, not...possible health and quality of life. Provider Contract Support Specialist Under general supervision, supports provider contracting department by… more
- Humana (Miami, FL)
- …and help us put health first** The Bilingual Telephonic Call Center Care Specialist / Care Coach 1 assesses and evaluates member's needs and requirements to ... the Blue Lagoon office. **Bilingual Telephonic Call Center Care Specialist / Care Coach 1:** + Inbound and Outbound...needs and hours could include weekends/holidays. + During the Medicare Annual Election Period, September to December, must be… more
- Tarrytown Rehabilitation & Nursing Center (Everett, MA)
- CLINICAL REIMBURSEMENT SPECIALIST / MULTI FACILITY We offer competitive compensation and benefit plans including: + Competitive Pay + Medical, Dental, Vision ... Team, and Atmosphere! We are seeking an experienced Clinical Reimbursement Specialist to support our MDS/MMQ teams in Massachusetts. The Clinical Reimbursement… more
- Humana (Tallahassee, FL)
- …and help us put health first** The Senior Program Delivery Specialist / Professional strategically identifies, develops, and implements programs that influence ... and/or improved quality metrics. Florida The Senior Program Delivery Specialist / Professional + Develops programs designed to drive value-based relationships.… more
- Medical Mutual of Ohio (Brooklyn, OH)
- **_The Claims/Customer Care Specialist - TPA position allows you the flexibility to work at home as long as you reside within a 50-mile radius of an Ohio Medical ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans....individual plans. Medical Mutual' s status as a mutual company means we are owned by our policyholders, not… more
- Medical Mutual of Ohio (OH)
- **Responsibilities** **COB Specialist I** Researches and responds to inquiries/issues to ascertain specifics of multiple health insurance coverages for members and ... companies. . Performs other duties as assigned. **Sr. COB Specialist ** Performs research to ascertain specifics of other coverage...Insurance (ODI) Rules of Order, ASO requirements and COBRA, Medicare and Medicaid rules. . Strong Knowledge of COB… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …consider collective experience, training and education. . 5 years as an Appeals Specialist or equivalent experience in Medicare health insurance claims, customer ... to appeal requests. Completes cases within the Center for Medicare & Medicaid Services (CMS) timeframes. . Utilizes the...and Compensation: + Employee bonus program. + 401(k) with company match up to 4% and an additional … more
- TEKsystems (Los Angeles, CA)
- …processing errors and denials. Payers include but are not limited to Medicare , Medicaid, Blue Cross, and commercial health insurance carriers. * Reduce outstanding ... increase cash flow Day to Day Duties: - Each specialist will be assigned an inventory to work. New...to account. Every account is different and the insurance company has either paid it and left a balance… more