• Mid Michigan Health (Midland, MI)
    …directs and refers patients for consults and/or testing and insurance pre- certification and documentation. (30%)* Greets patients and/or family, performs routine ... allergy reaction type, processes refills within the scope of their certification . (20%)* Assists provider with examinations and procedures. (20%)* Prepares and… more
    JobGet (06/09/24)
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  • Atrium Health (Charlotte, NC)
    …record using a multidisciplinary team process. Exhibits expertise associated with advanced certification in CDI. Partners with Medical and other leaders to achieve ... strategy, vision, mission, and goals. Ensures competency of Clinical Documentation Specialist staff by conducting on-going reviews and skills assessments; provides… more
    JobGet (06/06/24)
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  • Clinical Pharmacist - Medicare

    CVS Health (Richmond, VA)
    …help to support various Scorable Action Items (SAI) programs in the Medicare population, including Fraud, Waste, and Abuse (FWA), Formulary Education, Therapeutic ... for: + Performing pharmacy reviews and making evidence-based recommendations regarding Medicare members + Identifying opportunities within the health plan for… more
    CVS Health (06/05/24)
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  • Medical Certification Specialist 1-2

    Louisiana Department of State Civil Service (LA)
    …Medical Certification Specialist 2 by the absence of Centers for Medicare and Medicaid Services certification and by the level of independence exercised ... Medical Certification Specialist 1-2 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4531179) Apply  Medical Certification more
    Louisiana Department of State Civil Service (06/06/24)
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  • Licensing and Certification

    Synergy Healthcare Solutions (Dunwoody, GA)
    …| Salary | Synergy Healthcare Services - Atlanta | Full Time **Licensing & Certification Specialist ** **Health Care Billing** **This role is onsite in our ... Medicare and Medicaid enrollment, and local business licensing/permitting. As Licensing & Certification Specialist the primary purpose of your position is to… more
    Synergy Healthcare Solutions (05/02/24)
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  • Pre- Certification Specialist

    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
    Charter Care Health Partners (05/03/24)
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  • Outreach and Enrollment Specialist

    PruittHealth (Macon, GA)
    …MACON or ATHENS** **JOB PURPOSE:** The purpose of the Outreach and Enrollment Specialist role for PruittHealth Premier to serve as a licensed insurance agent to ... office space/work location is provided. The Outreach and Enrollment Specialist conducts the majority of their work within local...6. Ability to learn and carry out Centers for Medicare & Medicaid Services rules and regulations. 7. Meet… more
    PruittHealth (05/10/24)
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  • Provider Credentialing & Data Specialist

    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 general supervision, ... remote; Ohio residents preferred._** **Responsibilities** **Provider Credentialing & Data Specialist II** + Retrieves applications and/or data from central… more
    Medical Mutual of Ohio (06/08/24)
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  • Utilization Management Precertification…

    Universal Health Services (Auburn Hills, MI)
    …as well as Admission and Discharge Important Message from Medicare , uploads Medicare Certificates and updates MIDAS certification and Medicare Screens ... Responsibilities Utilization Management - Precertification Specialist HAVENWYCK HOSPITAL (a UHS facility) Havenwyck Hospital sa Joint Commission-accredited and… more
    Universal Health Services (06/03/24)
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  • IT Security Specialist III-V - Hybrid

    Medical Mutual of Ohio (Dublin, OH)
    …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Medical Mutual' s ... best possible health and quality of life. IT Security Specialist III Performs the more complex day to day...with audits and auditors to support and maintain corporate certification initiatives. + Performs other duties as assigned. IT… more
    Medical Mutual of Ohio (05/17/24)
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  • Consumer Access Specialist

    AdventHealth (Durand, WI)
    **Consumer Access Specialist - AdventHealth Durand** **All the benefits and perks you need for you and your family:** + Mission driven organization + Kind and caring ... patients** Verifies medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS)** **standards and communicates relevant coverage/eligibility… more
    AdventHealth (05/31/24)
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  • Business Systems Specialist

    Medical Mutual of Ohio (OH)
    …quarterly on-site requirement in Brooklyn, OH_** **Responsibilities** **Business Systems Specialist I** Works with management, external vendors, and Information ... more junior staff. . Performs other duties as assigned. **Business Systems Specialist II** Works with management, external vendors, and Information Systems to… more
    Medical Mutual of Ohio (04/19/24)
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  • Social Work Specialist

    AdventHealth (New Smyrna Beach, FL)
    …New Smyrna Beach **The role you'll contribute:** _The_ _Social Work Specialist intervenes with patients who have complex psychosocial needs, require assistance ... are provided and documented in a timely manner for compliance: Important Medicare Letters (IML), Medicare Outpatient Observation Notice (MOON), Patient Choice,… more
    AdventHealth (05/28/24)
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  • Senior Physician Specialist -…

    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 Required Questionnaire https://forms.office.com/g/2a7KLdZBTz… more
    City and County of San Francisco (03/29/24)
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  • Patient Service Specialist I - Patient…

    Health First (Palm Bay, FL)
    …secure the required forms to meet compliance with regulatory policies. 3. Perform Medicare compliance review on all applicable Medicare accounts to determine ... coverage. 4. Identify patients who may need Medicare Advance Beneficiary Notices of Noncoverage (ABNs). 5. Issue ABN forms as needed. 6. Complete Medicare more
    Health First (05/31/24)
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  • Medical Specialist 2

    New York State Civil Service (Thiells, NY)
    …the American Board of Medical Specialties (ABMS) in your specialty. OR* Medicaid and Medicare certified. OR* Current Medical Specialist 2. OR* Eligible for 70.1 ... Disabilities policies and regulations.* Maintain qualifications for Specialty and for Medicare and Medicaid certification of provider status.* Other duties… more
    New York State Civil Service (04/30/24)
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  • Coding Specialist Sr

    Baystate Health (Springfield, MA)
    …Coder (AAPC) CCA Certification = Certified Coding Associate (AHIMA) CCS Certification - Certified Coding Specialist (AHIMA) CCS-P Certification - ... **Coding Specialist Senior - PBO** **Summary Description:** _One to...Modification CPT Codes = Current Procedural Terminology CCI = Medicare Correct Coding Initiative ** Certification :** Certification more
    Baystate Health (06/05/24)
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  • Bereavement Program Specialist (Part-time)

    CareOregon (Portland, OR)
    …care costs and increase provider/care team satisfaction. Housecall Providers has saved Medicare millions of dollars, while providing better care to our patients, ... diseases. This trend will continue as roughly 10,000 baby boomers a day enter the Medicare system. If you receive an offer of employment for this position, it is… more
    CareOregon (05/17/24)
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  • Respiratory Specialist

    Bassett Healthcare (Little Falls, NY)
    …with the Medical Director of Respiratory Care Services, the Respiratory Specialist is responsible for assisting in the development, implementation, and ... administration of all policies and procedures. The Respiratory Care Specialist performs all roles and responsibilities of a Respiratory Therapist. The Respiratory… more
    Bassett Healthcare (05/24/24)
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  • Lab Technical Specialist

    Marshfield Clinic (Marshfield, WI)
    …awarded by the American Society for Clinical Pathology (ASCP). **Preferred/Optional:** Specialist certification through American Society for Clinical Pathology ... exciting missions in the world!** **Job Title:** Lab Technical Specialist -Hematology/Coagulation **Cost Center:** 201641056 Lab-Clinical Support **Scheduled Weekly Hours:**… more
    Marshfield Clinic (06/05/24)
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