- Medical Mutual of Ohio (OH)
- …and help our members achieve their best possible health and quality of life. ** Medicare Sales Operations Specialist ** Executes all end-to-end functions ... and other fulfillment needs identified for the business area. **Sr. Medicare Sales Operations Specialist ** Executes end-to-end functions relating… more
- Healthfirst (NY)
- …Provider Ops, Appeals & Grievance, Medical Management, Enrollment & Billing, Sales ) to identify, scope and accurately implement new benefits, services, or ... other product changes, update processes and/or edit systems to accommodate regulatory requirements + Assist with ad hoc projects such as focus group studies, process improvement initiatives and program implementations, when applicable + Coordinate activities… 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 ... high volume of claims per year for its US operations . The Care Manager will be responsible for medically...caseload of 65 including review of claims identified for Medicare Set-Aside. **What you will do** + Manage an… more
- Banner Health (AZ)
- …Arizona **Department Name:** Sales **Work Shift:** Day **Job Category:** General Operations Your pay and benefits are important components of your journey at ... optimal health, while reducing costs. POSITION SUMMARY This position directs the operations of Banner Plans and Networks government owned health plans including… more
- Sanofi Group (Bridgewater, NJ)
- **Job Title:** Specialist , Managed Care Operations **Location** : Bridgewater, NJ **About the Job** The Managed Care Specialist is responsible for contract ... management for various markets including Commercial Contracts, Medicare Part D and Managed Medicaid. This position will...providing insights and feedback on trends and issues. The Specialist will work in close cooperation with Managed Care… more
- 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 ... phone inquiries regarding COB from internal customers such as customer service, operations , and other insurance companies. . Performs other duties as assigned. **Sr.… more
- LA Care Health Plan (Los Angeles, CA)
- Product Solutions Specialist II Job Category: Sales & Marketing Department: Commercial and Group Product Management Location: Los Angeles, CA, US, 90017 Position ... the safety net required to achieve that purpose. Job Summary The Product Solutions Specialist II is focused on providing end to end development and management for… more
- Sumitomo Pharma (Greensboro, NC)
- …Co., Ltd. is a global pharmaceutical company based in Japan with key operations in the US (Sumitomo Pharma America, Inc.), Canada (Sumitomo Pharma Canada, Inc.) ... motivated, and experienced individual for the position of **MSPEC** Portfolio Specialist . The successful candidate will be responsible for compliantly driving… more
- Sevita (Charlotte, NC)
- …Join us, and experience a career well lived. **Accounts Receivable Collections Specialist ** Do you have experience in Accounts Receivable/Collections and a desire to ... impacts the lives of others? In the AR Collections Specialist role, you will contribute to the company's commitment...forms and provide appropriate support for refunds, cash moves, sales adjustments, and transfer of liability + Ensure internal… more
- UPMC (Pittsburgh, PA)
- UPMC Health Plan is hiring a full-time Clinical Pharmacy Specialist to support the Care Management team within the Pharmacy Services department. This is a ... licensure by examination or reciprocity is required. The Clinical Pharmacy Specialist provides clinical pharmacy expertise to the development, implementation and… more
- Gentiva (Columbus, OH)
- …travel 100% of the time throughout the region + Experience with Medicaid and Medicare reimbursement + Experience in health care sales and/or management with P&L ... day. **Overview** We are looking for an **Executive Director Specialist RN** . You will serve as the administrator...all federal and state guidelines. + Knowledge of hospice operations , state and federal regulations and compliance + Strong… more
- Gentiva (Bloomington, IN)
- …travel 100% of the time throughout the region + Experience with Medicaid and Medicare reimbursement + Experience in health care sales and/or management with P&L ... matters. **Overview** We are looking for an **Executive Director Specialist RN** . You will serve as the administrator...all federal and state guidelines. + Knowledge of hospice operations , state and federal regulations and compliance + Strong… more
- Gentiva (Myrtle Beach, SC)
- …travel 100% of the time throughout the region + Experience with Medicaid and Medicare reimbursement + Experience in health care sales and/or management with P&L ... lives every day. **Overview** We are looking for an **Executive Director Specialist RN** supporting our branches throughout North and South Carolina. You will… more
- All-Stat Portable (Skokie, IL)
- General Description We are seeking a skilled Billing Specialist to join our team. In this role, you are responsible for managing and overseeing the billing processes ... customer service, to resolve billing issues and ensure smooth financial operations . Responsibilities: Generate Invoices: + Prepare and issue invoices to customers… more
- Molina Healthcare (New York, NY)
- **JOB DESCRIPTION** **Job Summary** Molina Healthcare's Compliance team supports compliance operations for all Molina product lines enterprise wide. It is a ... is primarily responsible for supporting the day to day operations and initiatives of the Compliance Department. + Performs...+ Performs Plan Required Reporting. + Interpret and analyzes Medicare , Medicaid and Medicare Medicaid Plan Required… more
- Highmark Health (Harrisburg, PA)
- …outcomes as a result of workflow transformation, superior coding accuracy, and Medicare STARS gap closure to providers based upon each individual gain/risk share ... for superior coding accuracy, cost and utilization reports, medical loss ratio reports, Medicare STARS gaps and other risk revenue opportunities. + Function as the… more
- Grifols Shared Services North America, Inc (Houston, TX)
- …Learn more about Grifols (https://www.grifols.com/en/what-we-do) **Req ID:** 514460 **Type:** Regular Full-Time **Job Category:** Sales / Sales Operations ... our website: http://www.grifols.com **Overview:** Primary responsibility of the hospital sales representative is to represent the entire Grifols plasma portfolio… more
- NHS Management, LLC (Tuscaloosa, AL)
- …have extensive knowledge of Skilled Nursing Facility Billing including, but not limited to, Medicare Part A and B, Medicare Advantage and State Medicaid payers. ... office staff. Frequent travel is required. Responsibilities: + Oversee the daily operations of the billing and collections department, ensuring accurate and timely… 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 ... to the Training & Development team, handle office duties and optimize office operations . The Training Coordinator will provide oversight of the Tele- sales staff… more
- Catholic Health Initiatives (Bismarck, ND)
- …in the comment section.) + Maintains proficiency in Pharmacy Materials Management Specialist duties/responsibilities + Able to process order and put order away + ... Date check inventory + Process paperwork for medication sales to clinics and other entities + Able to...wholesaler ordering system + Actively participates in Retail Pharmacy operations as evidenced by + participates in ongoing training… more