- 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
- 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 ... of Medicare Advantage billing/claims submission and other related actions, preferred + Knowledge of HIPAA requirements, anatomy and physiology, required +… 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
- Healthfirst (NY)
- …of education and experience that would provide an equivalent background. ** Preferred Qualifications:** + Healthcare insurance and related experience + Experience ... with Microsoft Word, Excel, and PowerPoint + Strong organizational and project management skills + Some prior experience in the healthcare industry, specifically in health insurance + Strong work ethic, attention to detail, ability to effectively manage time,… more
- PruittHealth (Norcross, GA)
- …AA/AS in Accounting or Business (or Equivalent Education / Experience) preferred . **MINIMUM EXPERIENCE REQUIRED:** * Demonstrates experience and a proven track ... record in Insurance Claims in a medical setting of moderate size and complexity, information systems, and patient accounting applications, as typically acquired in1-3 years of patient accounting / medical billing positions * Experience in month end close… 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...of college degree CRCS Certification and or College Degree preferred Experience: 5 years in a Hospital setting with… 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
- 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)
- ….** **Professional Certification(s):** **.** **Certified Professional Coder (CPC) preferred .** **Technical Skills and Knowledge:** **.** **Strong knowledge of ... **_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)
- **_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 ... fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Medical Mutual' s… more
- Medical Mutual of Ohio (Brooklyn, OH)
- **_The Client Accounting Specialist position allows you the flexibility to work at home as long as you reside within a 50-mile radius of the Brooklyn, OH Medical ... fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Medical Mutual' s… more
- MetroLink (Los Angeles, CA)
- Finance Specialist I, Grants Finance (Limited Term) Print (https://www.governmentjobs.com/careers/scrra/jobs/newprint/4709470) Apply Finance Specialist I, ... Authority (SCRRA), operator of the Metrolink passenger rail service, is seeking a Finance Specialist I who will perform a wide variety of accounting work in accounts… more
- 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 ... achieve their best possible health and quality of life. **Document Services Specialist ** Executes database records, monitors and coordinates changes to the Document… more
- Henry Ford Health System (Troy, MI)
- …Certified Coding Specialist -Physician (CCS-P) or Certified Professional Coder (CPC), preferred . Skills and Abilities: + Ability to effectively lead a team. + ... GENERAL SUMMARY: The Lead Coding and Education Specialist will support the activities that assure compliant...and accurate reporting of the health status of HAP's Medicare Advantage (MA) and Commercial Qualified Health Plan (QHP)… more
- Medical Mutual of Ohio (Brooklyn, OH)
- … Medicare Supplement, and individual plans._** **Responsibilities** **Cash Recovery Specialist ** Reviews and research routine to moderately complex refunds and ... projects, etc.). . Performs other duties as assigned. **Senior Cash Recovery Specialist ** Reviews and research moderately complex to complex refunds and returned… more
- Premier Health (Dayton, OH)
- …are at or above standardized levels. The incumbent should be well versed in Medicare , Medicaid, and Research Billing policies. The Specialist serves as the ... System Research Charge Specialist MIAMI VALLEY HOSPITAL 1 WYOMING ST, DAYTON,...enrolled in clinical trials, for Premier Health based on Medicare Coverage rules and Clinical Trial contracts to ensure… 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 ... **_This position has the option to work remotely; Ohio residents preferred . Seeking applicants with project management and claims adjudication system experience._**… more