- Cognizant (Harrisburg, PA)
- …features. . Drive improvements in digital quoting, application intake, eligibility verification, and member onboarding for individual, group, and ... government-sponsored health plans (Medicare, Medicaid , ACA), ensuring compliance with CMS, ACA, and other...processes for individual, group, and government-sponsored health plans (Medicare, Medicaid , ACA). . Strong understanding of CMS, ACA, and… more
- CVS Health (Harrisburg, PA)
- …schemes. + Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business + Researches and prepares cases for clinical and legal ... year, depending on business needs) **Preferred Qualifications** + Previous Medicaid /Medicare investigatory experience + Exercises independent judgement and uses… more
- CVS Health (Harrisburg, PA)
- …practice experience. Two (2) + years of experience in managed care (Medicare and/or Medicaid ) MD or DO; Board certification in an ABMS or AOA recognized specialty is ... we have an Integrated plan. Experience with managed care (Medicare and Medicaid ) utilization review preferred. **Education** MD (Doctor of Medicine) or DO (Doctor… more
- Centene Corporation (Harrisburg, PA)
- …a subsidiary of Centene Corporation and will oversee program initiatives for the Medicaid product line of business encompassing HEDIS, and CAHPS by utilizing cross ... CAHPS, Quality Improvement projects, programs highly preferred. + Knowledge of Medicaid , Medicare government programs preferred. Pay Range: $68,700.00 - $123,700.00… more
- Community Legal Services, Inc. (Philadelphia, PA)
- …North Philadelphia office. Paralegals in the H&I Unit help clients navigate eligibility issues so clients can access public benefits that provide essential income ... and health coverage including TANF Cash Assistance, SNAP (Food Stamps), Medicaid , Medicare, LIHEAP, SSI and other Social Security benefits. Paralegals are integral… more
- Aveanna Healthcare (Carbondale, PA)
- …Qualifications + Experience with ID/DD individuals preferred, but not required + Proof of eligibility to work in the United States. + High school Diploma or GED. + ... ID/DD consumers preferred, but not required + Proof of eligibility to work in the United States. + High...Residing in California As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements… more
- Elevance Health (Harrisburg, PA)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. **Work Hours: Monday to Friday, ... caller questions via telephone and written correspondence regarding benefits, contracts, eligibility and claims. + Analyzes issues and provides information and/or… more
- Philips (Malvern, PA)
- …and developing systems /procedures to address issues. + Determining patient eligibility along with basic benefit verification (qualifying diagnoses, prior testing ... and authorization requirements) and reading eligibility of benefits, to determine claim processing by insurance...issue trends. + Knowledge of insurnace payers, including Medicare, Medicaid , Blue Cross Blue Shield and commercial plans. You… more
- Aveanna Healthcare (Hanover, PA)
- …Employee Stock Purchase Plan with 15% discount + Employee Relief Fund *Benefit eligibility can vary and is dependent upon employment status and employment location ... from diverse backgrounds to apply. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant… more
- Aveanna Healthcare (Exton, PA)
- …Employee Stock Purchase Plan with 15% discount + Employee Relief Fund *Benefit eligibility can vary and is dependent upon employment status and employment location ... of absence, compensation, and training. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all… more
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