- 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
- 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 their specific healthcare needs. This role is ideal… more
- 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...balances + Maintain patient demographic information and data collection systems Research and respond by telephone, via the internet… more
- PruittHealth (Norcross, GA)
- …In-depth knowledge of various billing documentation requirements, the patient accounting system , and various data entry codes to ensure proper service documentation ... functions in non-acute settings * Knowledge of Patient Management information system applications, preferably MatrixCare, as well as spreadsheet, word processing,… more
- CareOregon (Portland, OR)
- …Nevada, Texas, Montana, or Wisconsin. Job Title Sr Planning and Operations Specialist Department Medicare Exemption Status Exempt Requisition # 24639 Direct ... Reports N/A Manager Title Director, Medicare Network Performance Pay & Benefits Estimated hiring range...and timelines. + Develop, implement, and lead a monitoring system with visibility to metrics, reporting, and progress toward… more
- Elevance Health (Tampa, FL)
- …organization with health plans for people enrolled in Medicaid and/or Medicare programs in Florida. **Employment Specialist LTSS-Foster Care** **Location:** ... sites used for collaboration, community, and connection. The **Employment Specialist LTSS-Foster Care** is responsible for maintaining relationships with employers,… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …irregularities; determining continuing needs for Tele-Sale Agents, Benefit Navigators and Medicare Support Specialist . + Ensure all Tele-sale Agents, Benefit ... Navigators, and Medicare Support Specialists are conducting activities that are in...the Training Director + Maintain hard copy/ electronic filing system + Maintain office supply inventories + Record, compile,… more
- TEKsystems (Long Beach, CA)
- … Specialist is the single-point of contact for all assigned dual members (Medi-Cal/ Medicare ). The PAL Specialist manages all initial & annual outreach to each ... issues, & proactively assists members in navigating through healthcare & state eligibility systems . The PAL Specialist facilitates access to care with/on behalf… more
- Mount Sinai Health System (New York, NY)
- …:** Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight ... Description** A member of MSHS regulatory team, the Accreditation Specialist is a key leader and participant in the... is a key leader and participant in the systems continuous accreditation and regulatory readiness program. Responsible for… 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 ... individualized plan of care in the integrated care management system as needed. + Document all encounters with the...Management + 1-2 years of oncology nursing experience + Medicare and/or Medicaid experience with geriatric populations + Certified… more
- Ventura County (Ventura, CA)
- …of payment systems , including CPT, ICD-10, and HCPCS codes for Medicare and Medi-Cal payment processing. They are adept with the Medi-Cal Provider Manual ... for Medi-Cal and/or Medicare and prepares reports; + Serves as lead biller/ specialist to the department; and + Performs other related duties as required. Medical… more
- Marshfield Clinic (Marshfield, WI)
- …the most exciting missions in the world!** **Job Title:** Pharmacy Systems Support Specialist **Cost Center:** 301641243 Pharmacy-Billing **Scheduled Weekly ... pm (United States of America) **Job Description:** **JOB SUMMARY** The Pharmacy Systems Support Specialist helps facilitate and support the design, development,… 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. Under direct supervision, ... and credentialing into the various modules of the Provider Data Management System . Supports compliance with standards set by individual states, federal and… 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 ... best possible health and quality of life. Provider Contract Support Specialist Under general supervision, supports provider contracting department by developing and… more
- Mount Sinai Health System (New York, NY)
- …:** Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight ... **Job Description** The Compliance Resource Specialist (CRS) must have a broad knowledge and...+ Knowledge of CPT and ICD 9 and current Medicare and Medicaid rules regarding clinical documentation and billing… more
- Henry Ford Health System (Troy, MI)
- …SUMMARY: Reporting to the Manager, Revenue Integrity, the Revenue Integrity Senior Specialist has an important role in a high-profile group tasked with improving ... more senior Revenue Integrity leaders, the Revenue Integrity (RI) Senior Specialist is responsible for the facilitation of multiple Revenue Integrity initiatives… more
- Centers for Medicare & Medicaid Services (IN)
- …Group (HCSSG), Division of Systems and Reporting (DSR). As a Human Resources Specialist (Info Systems ), GS-0201-12, you will perform a wide variety of duties ... Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Office of Human Capital,...the CMS HR program. Serve as the primary HR Specialist (Info Systems ) at the technical level… more
- Atlantic Health System (Morristown, NJ)
- …credentials necessary to ensure initial credentialing and re-credentialing with Medicare , Medicaid, and Commercial Insurance Plans. Tracks enrollment applications ... Principal Accountabilities: Atlantic Medical Group is seeking a Full Time Credentialing Specialist . The Selected candidate will be responsible for review of the… more
- Veterans Affairs, Veterans Health Administration (North Chicago, IL)
- …Lovell FHCC is larger than just a single facility, but rather a system of facilities throughout Northeastern Illinois and Wisconsin which provide medical and dental ... management of the Integrity and Compliance Helpline and database tracking system ; overpayments; questionable conduct on the part of management, supervisors, or… more
- 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 I Performs the less complex, day to day...+ Interacts with users requests through the corporate provision system to ensure appropriate accesses are granted to … more