• Novo Nordisk Inc. (King Of Prussia, PA)
    …Relationships Externally, the DCS I maintain relationships with physicians, physician assistants, nurse practitioners, medical assistants, pharmacists, nurses and ... level impact Demonstrates understanding of the local payer market including Medicare , Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage… more
    HireLifeScience (11/03/24)
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  • Insmed Incorporated (Denver, CO)
    …- reimbursement and patient access, market access, specialty pharmacy, or physician /system account management Bachelor's degree required Experience working with HCP ... launch experience preferred Experience navigating payer reimbursement process, preferably Medicare Part D (pharmacy benefit design and coverage policy) Experience… more
    HireLifeScience (10/31/24)
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  • Lundbeck (Boston, MA)
    …internal and external partners and effectively addresses payer access issues ( Medicare , Medicaid, Commercial) using Lundbeck resources. Local Market & Therapeutic ... pharmacy benefit market Experience working with high influence customers in physician clinics, integrated health systems, infusion centers and alternative sites of… more
    HireLifeScience (10/23/24)
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  • Hospice Physician PRN

    BAYADA Home Health Care (Tucson, AZ)
    …and shall provide current proof of such registration upon Hospice's request. 6. Medicare and Medicaid Eligibility: Hospice Physician is and shall always remain ... a qualified Medicare and Medicaid provider. Hospice Physician represents and warrants that they have never been...care on a timely basis in accordance with applicable Medicare hospice regulations. Hospice Physician shall ensure… more
    BAYADA Home Health Care (10/10/24)
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  • Family Medicine without OB Physician

    HCA Healthcare (St. Petersburg, FL)
    …team is to provide a comprehensive, coordinated model of care to a mostly Medicare aged population. The Physician primarily manages the Geriatric - aged ... private practice is looking to add a Family Medicine Physician to their group located in St. Petersburg, Florida....their group located in St. Petersburg, Florida. **Summary** The Physician practices in a clinic, hospital or long term… more
    HCA Healthcare (10/15/24)
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  • Medicare Biller

    Trinity Health (Atlanta, GA)
    …+ Ability to research and resolve payment discrepancies. + Experience in physician offices with Medicare /Medicaid exposure is a plus. **Position Highlights ... regarding billing and claim processing. + Facilitate provider enrollment with physician staff. + Maintain the integrity and confidentiality of patient financial… more
    Trinity Health (10/30/24)
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  • Medicare Regional Provider Contracting…

    The Cigna Group (Bloomfield, CT)
    …and negotiating experience involving complex delivery systems and organizations required. Medicare Advantage experience required. + Experience with Physician , ... This job posting encompasses two **Regional Medicare ** **Provider Contracting Senior Managers** serves as an... product lines (eg, Hospital systems, ancillaries, and large physician groups) for one or more geographies. + Proactively… more
    The Cigna Group (10/25/24)
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  • (Remote/Hybrid) Integrity and Compliance…

    Trinity Health (Livonia, MI)
    …efforts for professional services which relies on a thorough understanding of the Medicare Physician Fee Schedule, Medicare Claims Processing Manual, ... knowledge base is preferred. 3. Must have an in-depth knowledge of Medicare and Medicaid documentation, coding, and billing regulations for applicable service… more
    Trinity Health (09/28/24)
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  • Director, Market Innovation

    American Academy of Family Physicians (Leawood, KS)
    …related market-centric topics including but not limited to **fee-for-service payment** ( Medicare Physician Fee Schedule, RUC, CPT, etc.) **value-based payment** ... Family Physicians and its chapters proudly represent more than 130,000 family physician , resident, and medical student members. Family physicians play a critical… more
    American Academy of Family Physicians (09/28/24)
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  • Healthcare Resource Specialist Full-Time Days…

    Trinity Health (Boise, ID)
    …knowledge of medical terminology and the healthcare system (insurances, Medicare , Medicaid, physician office operations) preferred. **ESSENTIAL FUNCTIONS:** ... collaborate with multiple clinics to best utilize resources while accommodating physician preference and patient needs consistent with Saint Alphonsus values and… more
    Trinity Health (11/01/24)
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  • Precertification Rep

    HCA Healthcare (Nashville, TN)
    …Peer function as needs arise** + **Checks patient orders for compliance with Medicare guidelines** + **Processes physician 's orders in accordance with department ... enters all mandatory information. Provides instructions to patients and physician 's staff on authorization requirements and information. Establish and maintain… more
    HCA Healthcare (10/30/24)
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  • Sr. Compliance Auditor Trainer

    Johns Hopkins University (Baltimore, MD)
    …billing. + Keeps current with third party regulations with emphasis on Medicare billing, teaching physician regulations, Current Procedural Terminology, ICD-9-CM ... **Trainer** who will provide on-going training and support to physicians, non- physician providers, professional fee billing staff, clinic staff, administrators, and… more
    Johns Hopkins University (10/15/24)
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  • Medicare Cost Reporting and Reimbursement…

    Vanderbilt University Medical Center (Nashville, TN)
    …or decision support analytics in a large healthcare environment, hospital, physician practice, third party payer, Medicare intermediary or accounting/consulting ... level decision support analytics in a large healthcare environment, hospital, physician practice, third party payer, Medicare intermediary or… more
    Vanderbilt University Medical Center (10/25/24)
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  • Senior Medicare Coverage Analyst

    Dana-Farber Cancer Institute (Brookline, MA)
    …for this position is full remote with occasional time onsite.** The Medicare Coverage Analyst (MCA) is responsible for reviewing clinical research protocols, ... insurance and which should be billed to the study sponsor. The Medicare Coverage Analyst determines whether proposed clinical research studies are a Qualifying… more
    Dana-Farber Cancer Institute (10/22/24)
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  • Medicare Provider Performance Enablement…

    The Cigna Group (Sunrise, FL)
    …conduit to the providers and the individual that represents Cigna Medicare Advantage. The Provider Performance Enablement Lead Analyst's responsibilities include: + ... + Supporting the development, management and oversight of the physician / provider network in the assigned **Treasure Coast, FL...members contribute to the growth and profitability of the Medicare Advantage business in their market in the following… more
    The Cigna Group (10/03/24)
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  • Medicare Provider Performance Enablement…

    The Cigna Group (Denver, CO)
    …conduit to the providers and the individual that represents Cigna Medicare Advantage. The Provider Performance External Representative's responsibilities include: + ... Supporting the development, management and oversight of the physician / provider network in his/her assigned **territories.** + Establishing and managing strong,… more
    The Cigna Group (08/24/24)
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  • Medicare Biller

    Insight Global (Cincinnati, OH)
    Job Description Insight Global is looking for a Medicare Biller for a contract to hire opportunity in the Blue Ash area of Cincinnati. This person will be joining a ... claims for a large health system (both in patient hospital and out patient physician claims). This person will be primarily responsible for medicare billing,… more
    Insight Global (10/01/24)
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  • Medicare Provider Performance Enablement…

    The Cigna Group (Seattle, WA)
    …include: + Supporting the development, management and oversight of the physician / provider network in his/her assigned Washington territory. + Establishing and ... for and participates in meetings with providers, provider staff, and/or physician leadership including creating and delivering presentations. + Collaborating with… more
    The Cigna Group (10/26/24)
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  • Medical Director - Medicare

    Molina Healthcare (Phoenix, AZ)
    …medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews quality referred ... Improvement activities. + Stabilizes, improves and educates the Primary Care Physician and Specialty networks. Monitors practitioner practice patterns and recommends… more
    Molina Healthcare (11/02/24)
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  • Medicare Nurse Reviewer

    Medical Mutual of Ohio (OH)
    …inpatient admissions, concurrent, and retrospective reviews in collaboration with physician reviewers. Applies evidence-based discharge planning so that patients ... and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind… more
    Medical Mutual of Ohio (11/01/24)
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