- Novo Nordisk Inc. (San Mateo, CA)
- …level impact Demonstrates understanding of the local payer market including Medicare , Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage ... experience working in one or more of the following areas preferred : Pharmaceutical/Healthcare, Sales, Consulting, Customer Service or Military Relevant Novo Nordisk… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …and home office stakeholders. External relationships include Managed Care & Medicare customers, Market Access and System Vendors. Essential Functions Assists ... required Microsoft Access, and Advanced skills in Excel required SQL experience preferred Requires a minimum of 4 years relevant experience Strong analytical,… more
- Merck & Co. (Minneapolis, MN)
- …integration with the Key Account Manager, Nurse Educator, Field Reimbursement Associate, Medicare Account Executive, and other key stakeholders to share key customer ... drive a motor vehicle. Travel the amount of time the role requires. Preferred Experience and Skills: 2+ years of oncology field sales experience. Documented history… 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
- 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
- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and ... of Medicare Advantage billing/claims submission and other related actions, preferred + Knowledge of HIPAA requirements, anatomy and physiology, required +… more
- VNS Health (Manhattan, NY)
- OverviewThe Medicare Enrollment Specialist educates consumers who have reached out to VNS Health Plans and existing VNS Health Plans MLTC members about the ... 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)
- …in a professional manner; both verbally and written + Certified Billing and Coding Specialist (CBCS) preferred but not required . **Education** + High School ... also provides free parking. **What you will do** + Timely response to Medicare audits and appeals + Research and gather the appropriate documentation to form… more
- PruittHealth (Norcross, GA)
- …AA/AS in Accounting or Business (or Equivalent Education / Experience) preferred . **MINIMUM EXPERIENCE REQUIRED:** * Demonstrates experience and a proven track ... record in Insurance Claims in a medical setting of moderate size and complexity, information systems, and patient accounting applications, as typically acquired in1-3 years of patient accounting / medical billing positions * Experience in month end close… 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)
- **_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 ... fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Medical Mutual' s… 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 ... achieve their best possible health and quality of life. Payment Control Specialist I Processes routine corporate cash receipts and adjustments. Balances daily cash… more
- Medical Mutual of Ohio (OH)
- …Medicare Supplement, and individual plans. **Responsibilities** **Business Systems Specialist I** Works with management, external vendors, and Information Systems ... . Basic proficiency with Power BI, Tableau, SQL tools preferred . **Business Systems Specialist II** . Bachelor's...self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans.… more
- Medical Mutual of Ohio (OH)
- …metrics. **_This position has the option to work remote; Ohio residents preferred ._** **Responsibilities** **Provider Credentialing & Data Specialist I** + ... insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Under direct supervision,… 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 ... . Responds to a variety of member inquiries from commercial and Medicare Advantage product lines through determined channels such as telephone, written, email,… 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
- 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 (OH)
- **Responsibilities** **COB Specialist I** Researches and responds to inquiries/issues to ascertain specifics of multiple health insurance coverages for members and ... and other insurance companies. . Performs other duties as assigned. **Sr. COB Specialist ** Performs research to ascertain specifics of other coverage for members and… 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 ... fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Medical Mutual' s… more
