- Medical Mutual of Ohio (OH)
- …+ Performs other duties as assigned. **Sr. Medicare Sales Operations Specialist ** + Executes annual agent certification training, which includes planning, ... help our members achieve their best possible health and quality of life. ** Medicare Sales Operations Specialist ** Executes all end-to-end functions relating to… 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 ... internal and external partners, assisting with the administration of Medicare programs, and other projects assigned to support the...or equivalent + Certified Pharmacy Tech experience + CPHT Certification + 2 years of retail pharmacy experience +… 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 ... highly organized, detail-oriented individual with: + A Certified Professional Coder (CPC) certification or Certified Coding Specialist (CCS) certification ,… 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...revenue cycle/process experience in lieu of college degree CRCS Certification and or College Degree preferred Experience: 5 years… 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
- 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
- Medical Mutual of Ohio (OH)
- …least 2 years of which is as a Medical Record Retrieval Specialist .** **Professional Certification (s):** **.** **Certified Professional Coder (CPC) preferred.** ... **_The Medical Record Retrieval Specialist position allows you the flexibility to work...self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans.… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …or related field.** **.** **5 years of experience as a Sourcing Specialist or equivalent experience.** **Professional Certification (s):** . Certified Purchasing ... or related field.** **.** **7 years of experience as a Sourcing Specialist or equivalent experience.** **Professional Certification (s):** . Certified Purchasing… more
- New York State Civil Service (Thiells, NY)
- …Disabilities policies and regulations.* Maintain qualifications for Specialty and for Medicare and Medicaid certification of provider status.* Other duties ... Yes Agency People With Developmental Disabilities, Office for Title Medical Specialist 2 Occupational Category Health Care, Human/Social Services Salary Grade 38… more
- Charter Care Health Partners (Providence, RI)
- …all authorizations and pre-certs as required by the individual insurance company. The specialist will be familiar with and understand Medicare , Medicaid, other ... government payers, Commercial and HMO/PPO Payers guidelines and principals. Education: High school graduate or GED required. Associate's level degree preferred. Experience: Prior experience working in a related role in a medical office or other health care… more
- New York State Civil Service (Brooklyn, NY)
- …Yes Agency People With Developmental Disabilities, Office for Title Medical Specialist 2 (NY HELPS) Occupational Category Health Care, Human/Social Services Salary ... Code 11239 Duties Description Primary Duties and ResponsibilitiesAs a Medical Specialist , you would actively participate in diagnosing and treating patients within… more
- New York State Civil Service (Rochester, NY)
- …Yes Agency People With Developmental Disabilities, Office for Title Medical Specialist 1 (NY HELPS) Occupational Category Health Care, Human/Social Services Salary ... Code 14620 Duties Description Primary Duties and Responsibilities:As a Medical Specialist , you would actively participate in diagnosing and treating patients within… more
- University of Colorado (Aurora, CO)
- …as Medicaid or Medicare , or other resources available to patients. + Possess certification as a Colorado Peer and Family Specialist (CPFS), or another Peer ... the training already. + The employee must obtain the Colorado Peer and Family Specialist (CPFS) certification within 6 months of hire date ( certification … 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. _Collaborates with ... with providers.** + **Medical /clinical background highly desirable.** **Professional Certification (s)** + **Registered Nurse preferred** + **Certified Professional Coder… 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
- Health First (Melbourne, FL)
- …and secure the required forms to meet compliance with regulatory policies. 3. Perform Medicare compliance review on all applicable Medicare accounts in order to ... determine coverage. Identify patients who may need Medicare Advance Beneficiary Notices of Noncoverage (ABNs). Issues ABN forms as needed. 4. Complete Medicare … more
- City and County of San Francisco (San Francisco, CA)
- …required documentation for credentialing + Possess a valid third-party billable provider certification (such as Medicare , Medi-Cal, and/or private insurance) OR ... Public Health continuously accepts applications for all Senior Physician Specialist positions. + ✅Start with this Questionnaire https://forms.office.com/g/2a7KLdZBTz +… 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 ... denial issues related to appeal requests. Completes cases within the Center for Medicare & Medicaid Services (CMS) timeframes. . Utilizes the appropriate systems and… more
- Marshfield Clinic (Marshfield, WI)
- …are substantially related to the position. **Minimum Required** : Certified Child Life Specialist (CCLS) certification awarded by the Association of Child Life ... Red Cross within one month of hire. **Preferred/Optional:** Certified Therapeutic Recreation Specialist (CTRS) certification awarded by the National Council for… more
- HCA Healthcare (Nashville, TN)
- …Eligible* Do you have the career opportunities as an Inpatient Coding Denial Specialist you want with your current employer? We have an exciting opportunity for ... preferred banking partnerships + Education assistance (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time… more
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