- Walworth County (Elkhorn, WI)
- Medicare Specialist (HHS) Print (https://www.governmentjobs.com/careers/walworthco/jobs/newprint/3201106) Apply Medicare Specialist (HHS) Salary $18.70 ... Equal Opportunity Employer Position Summary This position is responsible for assisting Medicare beneficiaries with enrollment issues regarding Medicare Part D, … more
- Corewell Health (Grand Rapids, MI)
- Job Summary The Medicare Quality Specialist , Pharmacy will assist the Medicare Adherence Pharmacists Team to improve Medicare Star Ratings and CAHPS by ... collaboration with internal and external partners, assisting with the administration of Medicare programs, and other projects assigned to support the Medicare … 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
- Medical Mutual of Ohio (OH)
- …help our members achieve their best possible health and quality of life. ** Medicare Sales Operations Specialist ** Executes all end-to-end functions relating to ... and other fulfillment needs identified for the business area. **Sr. Medicare Sales Operations Specialist ** Executes end-to-end functions relating to… more
- Medical Mutual of Ohio (OH)
- …substance abuse and nicotine testing._ **Title:** _Clinical Services Support Specialist ( Medicare UM)_ **Location:** _Ohio_ **Requisition ID:** _2400556_ ... insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Under general… 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 ... with: + A Certified Professional Coder (CPC) certification or Certified Coding Specialist (CCS) certification, required + A Certified Risk Adjustment Coder (CRC),… more
- Robert Half Finance & Accounting (Bridgewater, NJ)
- Description + Handle billing for Medicare patients, ensuring all claims are submitted correctly and promptly + Review and resolve any denials or underpaid claims + ... and resubmit rejected and/or denied claims + Communicate with Medicare and patients about any discrepancies or issues with...issues with billing + Understand and adhere to all Medicare Compliance policies + Stay updated on current … more
- University of Washington (Seattle, WA)
- …has an outstanding opportunity for a **full-time, day shift, INSURANCE FOLLOW-UP SPECIALIST (Patient Account Representative 2).** **WORK SCHEDULE** + 40 hours per ... Shift + This position is Remote **POSITION HIGHLIGHTS** The Insurance Follow-up Specialist is responsible for the optimal payment of claims from commercial insurers,… 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
- Healthfirst (NY)
- …+ Leads or participates in product-driven workgroups, to provide input to product designs/enhancements and implementation plans + Works with key stakeholders ... (including, but not limited to Regulatory, Claims Configuration, Provider Ops, Appeals & Grievance, Medical Management, Enrollment & Billing, Sales) to identify, scope and accurately implement new benefits, services, or other product changes, update processes… more
- Sea Mar Community Health Centers (Mount Vernon, WA)
- …by contracted entities such as Accountable Communities of Health and Medicaid/ Medicare organizations. + The TOC Integration Specialist must maintain the ... a mandatory COVID-19 and flu vaccine organization Transition of Care Integration Specialist - Posting #27118 Hourly Rate: $26.52 Position Summary: Sea Mar Community… 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
- 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...to appropriate area for review. . Facilitates processing of Medicare appeals to the independent review entity (IRE) .… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- The Medicare Billing and Follow-up Representative are responsible for the compliant, accurate and timely billing and follow-up of all hospital Medicare and ... limited as other tasks may be assigned. + Submit Medicare / Medicare Advantage plan claims both electronic and...Licenses, Registrations Applicants must be a Certified Revenue Cycle Specialist (CRCS) upon hire or within twelve months of… 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
- Lowe's (Charlotte, NC)
- …treatment to an appropriate resolution. Apply medical treatment guidelines for future Medicare -covered expenses. The candidate will work directly for a Fortune 100 ... caseload of 65 including review of claims identified for Medicare Set-Aside. **What you will do** + Manage an...Rehabilitation Registered Nurse + CDMS - Certified Disability Management Specialist + COHN - Certified Occupational Health Nurse or… more
- Banner Health (AZ)
- …a direct interface with the Arizona Medicaid Agency (AHCCCS), Center of Medicare and Medicaid Services (CMS), Association for Community Affiliated Plans (ACAP), and ... Healthcare Facility Manager (CHFM); Certified Facility Manager (CFM); Certified Coding Specialist (CCS); Certified Professional Coder (CPC); JD from an American Bar… 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
- 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 Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4539404) Apply Medical Billing Specialist III/IV Salary… 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 ... health and quality of life. **Responsibilities** **Medical Coding Compliance Specialist I** Optimizes/reviews documentation for the application of risk adjustment… more
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