- Memorial Health (Marysville, OH)
- …strong communicator to join our team as Revenue Integrity Specialist .**If interested, please apply on our website at https://memorialohio.com/join-our-team/*The ... primary objective of the Revenue Integrity Specialist is to identify and prevent recurrence of issues that may cause revenue leakage and/or billing compliance risks.… more
- Atrium Health (Charlotte, NC)
- …strategy, vision, mission, and goals. Ensures competency of Clinical Documentation Specialist staff by conducting on-going reviews and skills assessments; provides ... and understanding of severity based DRG systems; All-Patient Refined and Medicare Severity (APR-DRG), Medical Severity Diagnostic Related Group System (MS-DRG) and… more
- Elderwood (Buffalo, NY)
- …Medical Billing Specialist to join our team. Medical Billing Specialist ( Medicare /Managed Care) Position Overview: + Elderwood Administrative Services is ... Life Insurance, Medical, Dental, and Vision insurance Responsibilities Medical Billing Specialist ( Medicare /Managed Care): + Review remittances for potential… more
- Wider Circle (Mcallen, TX)
- …a fast-growing boutique insurance agency focused on helping people understand their Medicare Benefits. We work with underserved populations to help them navigate ... Medicare to identify the best benefits for their needs....Ask Claire is looking for a remote telephonic Outreach Specialist to join our fast-paced team to connect with… more
- PruittHealth (Norcross, GA)
- **JOB PURPOSE:** Supports the delivery of all Medicare billing services by final/higher level auditing, correcting, and submitting claims. Ensures that billing ... productivity performance standards, are familiar with the rules and regulations of Medicare billing and are skilled at problem solving and account resolution. They… more
- Houston Methodist (Katy, TX)
- Medicare compliance experience is preferred ** **Note: Office for this position is located at our Continuing Care Hospital:** **701 S. Fry Rd. Katy, TX 77450** ... **. (Hybrid position)** At Houston Methodist, the CBO Regulatory Compliance Specialist position is responsible for working with Houston Methodist's Corporate Central… more
- ProMedica Health System (Toledo, OH)
- …billing, accounting, or business experience with and third party billing experience preferred . Medicare experience required. 3. Physical Demands: Work is ... Responsible for Daily Review of outstanding and incoming Medicare Additional Development Requests (ADRs). Responsibilities: 1. Maintains updated files as changes… more
- Prime Therapeutics (Columbus, OH)
- …fuels our passion and drives every decision we make. **Job Posting Title** Medicare Health Plan Operations Specialist - Remote **Job Description** The Associate ... presentations + Proficiency in Microsoft Word, Excel, PowerPoint, Project and Visio ** Preferred Qualifications** + Rx Claims system proficiency + Previous PBM or… more
- Sunrise Senior Living (Arlington, VA)
- …(P&L) Summary reporting - Review balance sheet account reconciliations - Medicare /Medicaid billing - Adherence to Sunrise Senior Living business process controls ... **Qualifications:** - Associate degree in Accounting or related field preferred - Two (2) years experience in accounting field with exposure to accounting services… more
- 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
- Commonwealth Care Alliance (Boston, MA)
- …This Role is Important to Us:** Under direction of the Director of Medicare Compliance, the primary focus areas of this position include development and oversight ... includes: Corrective Action Plan (CAP) management, regulatory reporting to Centers for Medicare & Medicaid Services (CMS), State Agencies and Department of Insurance… more
- CVS Health (Albany, NY)
- …Accountable Care organization. This position will focus on beneficiaries enrolled in Medicare Advantage plans to provide resources and assistance to drive STARS ... and allied health professionals to support the needs of Medicare beneficiaries + Speak one on one with ...states if required + Performs other duties as required Preferred Qualifications + Residency training + Board Certified Ambulatory… more
- The Cigna Group (Bloomfield, CT)
- …follow up contact, which may include primary care physician and specialist appointment scheduling. + Provide clinical assessments, health education, and utilization ... years experience in acute care, home health or case management experience. + Medicare and/or Medicaid experience with geriatric populations a plus + Certified Case… more
- Medical Mutual of Ohio (OH)
- … Specialist I** . Implements marketing strategies for consumer-facing Medicare and Individual ACA campaigns. . Develops and manages marketing collateral ... Specialist II** . Implements marketing strategies for consumer-facing Medicare campaigns. . Develops and manages marketing collateral and sales materials… more
- Martin's Point Health Care (Portland, ME)
- … Medicare Specialist ) or TRICARE (for USFHP Specialist ) appeals processes and regulations strongly preferred Skills/Knowledge/Competencies (Behaviors): ... since 2015. Position Summary Job Description Position Summary: The Appeals Specialist ( Medicare or US Family Health Plan) is responsible for ensuring… more
- Medical Mutual of Ohio (OH)
- **_The Proposal Specialist position allows you the flexibility to work at home as long as you reside within a 50-mile radius an Ohio Medical Mutual office._** ... fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Medical Mutual' s… more
- InnovaCare (Ponce, PR)
- …passion and customer focus to the business. POSITION DESCRIPTION The Quality Specialist Nurse is responsible for monitoring quality of care and services delivered ... of experience in clinical nursing. Previous QA review experience preferred . GENERAL SKILLS AND KNOWLEDGE + Must have ability...management in North America. Through two it's main ways, Medicare Advantage and the provider network, we are committed… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Responsibilities** **Learning ... & Development Specialist I** Delivers, develops, and implements corporate or divisional...in a financial services environment. . Certified Professional Trainer preferred (or working towards designation). . Knowledge of and… more
- 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
- MetroLink (Los Angeles, CA)
- Special Services Employee (TEMP) - Finance Specialist II (Accounts Payable) Print (https://www.governmentjobs.com/careers/scrra/jobs/newprint/4435696) Apply ... Special Services Employee (TEMP) - Finance Specialist II (Accounts Payable) Salary $1,827.77 - $2,834.85 Biweekly...(10) Health Maintenance Organization (HMO) plans and two (2) Preferred Provider Organization (PPO) plans. Some health plans are… more
