• Medical Billing Specialist

    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
    Elderwood (11/18/24)
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  • Medicare Sales Specialist (Remote…

    CVS Health (Nashville, TN)
    …sales talent! We have an exciting opportunity available for highly motivated individuals as Medicare Sales Specialist . The position will be a part of a ... specialized team who will focus on educating existing Medicare members on available plan offerings to help meet...understanding of products, services, and processes offered by the company . + Expert level of MAPD/DSNP product offerings Ability… more
    CVS Health (10/08/24)
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  • Clinical Services Support Specialist

    Medical Mutual of Ohio (OH)
    …substance abuse and nicotine testing._ **Title:** _Clinical Services Support Specialist ( Medicare UM)_ **Location:** _Ohio_ **Requisition ID:** _2400556_ ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans....and Compensation: + Employee bonus program. + 401(k) with company match up to 4% and an additional … more
    Medical Mutual of Ohio (11/16/24)
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  • Medicare Enrollment Specialist

    VNS Health (Manhattan, NY)
    OverviewThe Medicare Enrollment Specialist educates consumers who...at 30 days of paid time off and 9 company holidays + Health insurance plan for you and ... who contact VNS Health Plans via website about VNS Health Plans Medicare products. Qualifications Licenses and Certifications: + NYS Health Insurance License,… more
    VNS Health (11/27/24)
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  • Medicare Billing Collections…

    CVS Health (Monroeville, PA)
    …also provides free parking. **What you will do** + Timely response to Medicare audits and appeals + Research and gather the appropriate documentation to form ... all levels of appeals for Medicare + Third party follow-up associated with the dispensing...both verbally and written + Certified Billing and Coding Specialist (CBCS) preferred but not required . **Education** +… more
    CVS Health (10/26/24)
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  • Senior Manager, Medicare Product…

    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
    Point32Health (11/08/24)
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  • Assistant Director Medicare Advantage Risk…

    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
    UCLA Health (11/27/24)
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  • Payment Control Specialist I- Sr.

    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 ... status as a mutual company means we are owned by our policyholders, not...best possible health and quality of life. Payment Control Specialist I Processes routine corporate cash receipts and adjustments.… more
    Medical Mutual of Ohio (10/24/24)
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  • Sourcing Specialist

    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 ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans....individual plans. Medical Mutual' s status as a mutual company means we are owned by our policyholders, not… more
    Medical Mutual of Ohio (10/17/24)
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  • PAR - Membership Services Specialist I

    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 ... status as a mutual company means we are owned by our policyholders, not...to a variety of member inquiries from commercial and Medicare Advantage product lines through determined channels such as… more
    Medical Mutual of Ohio (11/23/24)
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  • Business Systems Specialist

    Medical Mutual of Ohio (OH)
    Medicare Supplement, and individual plans. **Responsibilities** **Business Systems Specialist I** Works with management, external vendors, and Information Systems ... staff. . Performs other duties as assigned. **Business Systems Specialist II** Works with management, external vendors, and Information...and Compensation: + Employee bonus program. + 401(k) with company match up to 4% and an additional … more
    Medical Mutual of Ohio (11/07/24)
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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 direct supervision, ... remote; Ohio residents preferred._** **Responsibilities** **Provider Credentialing & Data Specialist I** + Categorizes returned mail and determines action needed… more
    Medical Mutual of Ohio (10/30/24)
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  • Provider Contract Support Specialist - Sr.

    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 ... status as a mutual company means we are owned by our policyholders, not...possible health and quality of life. Provider Contract Support Specialist Under general supervision, supports provider contracting department by… more
    Medical Mutual of Ohio (10/22/24)
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  • Bilingual Call Center Specialist

    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 (11/19/24)
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  • Clinical Reimbursement Specialist / Multi…

    Tarrytown Rehabilitation & Nursing Center (Everett, MA)
    CLINICAL REIMBURSEMENT SPECIALIST / MULTI FACILITY We offer competitive compensation and benefit plans including: + Competitive Pay + Medical, Dental, Vision ... Team, and Atmosphere! We are seeking an experienced Clinical Reimbursement Specialist to support our MDS/MMQ teams in Massachusetts. The Clinical Reimbursement… more
    Tarrytown Rehabilitation & Nursing Center (10/31/24)
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  • Senior Program Delivery Specialist

    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
    Humana (11/23/24)
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  • Claims/Customer Care Specialist -TPA

    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 ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans....individual plans. Medical Mutual' s status as a mutual company means we are owned by our policyholders, not… more
    Medical Mutual of Ohio (11/27/24)
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  • COB Specialist

    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 ... companies. . Performs other duties as assigned. **Sr. COB Specialist ** Performs research to ascertain specifics of other coverage...Insurance (ODI) Rules of Order, ASO requirements and COBRA, Medicare and Medicaid rules. . Strong Knowledge of COB… more
    Medical Mutual of Ohio (11/23/24)
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  • Sr Appeals Specialist

    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...and Compensation: + Employee bonus program. + 401(k) with company match up to 4% and an additional … more
    Medical Mutual of Ohio (11/14/24)
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  • Insurance Specialist

    TEKsystems (Los Angeles, CA)
    …processing errors and denials. Payers include but are not limited to Medicare , Medicaid, Blue Cross, and commercial health insurance carriers. * Reduce outstanding ... increase cash flow Day to Day Duties: - Each specialist will be assigned an inventory to work. New...to account. Every account is different and the insurance company has either paid it and left a balance… more
    TEKsystems (11/16/24)
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