- National Health Care Associates (Stafford Springs, CT)
- …appreciated. We invite you to join our team! **-** **What You'll Do:** As a Medicaid Specialist , you will support the center's business office in processing ... are valued and appreciated, we invite you to join our team as a Medicaid Specialist **-** **What We Offer** As an affiliate of National Health Care, our… more
- National Health Care Associates (Stafford Springs, CT)
- …Direct care in a long-term care setting, MDS Coordinator, Clinical Reimbursement Specialist or Nurse Assessment Coordinator experience preferred + Knowledge of state ... federal regulations governing the MDS, Electronic Medical Record (EMR), PDP, MDS 3.0, Medicaid and Medicare requirements helpful + Interest in the nursing needs of… more
- Highmark Health (Providence, RI)
- …medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation ... Professional Coder (CPC) + Certified Risk Coder (CRC) + Certified Coding Specialist (CCS) + Registered Health Information Technician (RHIT) **Preferred** + None… more
- Charter Care Health Partners (Providence, RI)
- …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 related organization. 2-3 years of prior insurance verification and… more
- Novo Nordisk (Norwich, CT)
- …of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage Requirements, Step Therapy, ... Coverage Gap, Copays, and Deductibles and the impact on customer decisions + Demonstrates understanding of territory customer groups and affiliations such as IPAs, Medical Groups, Health Systems, and Local Clinics and uses this to identify business… more
- Cardinal Health (Providence, RI)
- …secondary insurance company when necessary. + Bills supplemental insurances including all Medicaid states on paper and online. + Oversees appeals and denials ... management to maximize revenue recovery and minimize financial leakage, ensuring all claims are accurately processed and followed up in a timely manner. + Manages billing queue as assigned in the appropriate system. + Investigates and updates the system with… more
- Hartford HealthCare (Norwich, CT)
- …and standards by The Joint Commission (TJC), Center for Medicare and Medicaid (CMS), and Connecticut Department of Public Health (DPH). *Education: *Associate's ... *National Association Medical Staff Services (NAMSS) Certified Provider Credentialing Specialist (CPCS) required. If not certified, obtain certification within 1… more
- Evolent (Providence, RI)
- …Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the ... or sanction by any state or federal health care program, including Medicare or Medicaid , and is not identified as an "excluded person" by the Office of Inspector… more
- Cardinal Health (Providence, RI)
- …authorization through billing and collections. Job Purpose: The Patient AR Specialist is responsible for managing and resolving outstanding patient balances, ... claim processing and denial management preferred. + Familiarity with Medicare, Medicaid , commercial insurance plans, and managed care preferred. + Proficiency in… more
