- Humana (Harrisburg, PA)
- …preferably in the health care or insurance industry, and specifically in Medicare Advantage products + Exceptional leadership and management skills, and the ability ... **Preferred Qualifications:** + Master's Degree + Knowledge of the Medicare Advantage market, products, regulations, and compliance standards **Additional… more
- CVS Health (Harrisburg, PA)
- …applicable) to ensure the ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... International Classification of Disease (ICD) codes required. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical… more
- CVS Health (Harrisburg, PA)
- …records coded by internal teams prior to the submission to the Centers of Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... record documentation review, diagnosis coding, and/or auditing. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical… more
- Elevance Health (Harrisburg, PA)
- …member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services ... a BA/BS degree and a minimum of 5 years of audit/reimbursement or related Medicare experience; or any combination of education and experience, which would provide an… more
- Prime Therapeutics (Harrisburg, PA)
- …related partner/customer relationships including pharmaceutical manufacturers, with specific emphasis on Medicare Part D and Managed Medicaid. The Sr Director, Pharm ... + Direct the oversight of Trade formulary strategies for Commercial, Exchange, Medicare Part D and/or Medicaid template formularies, including items such as… more
- Intermountain Health (Harrisburg, PA)
- …with ICD-10-CM and Official Coding Guidelines as determined by Centers for Medicare and Medicaid Services (CMS), National Center for Health Statistics (NCHS), US ... skills. AND Demonstrated knowledge of government benefits and regulations related to Medicare , Medicaid or the ACA. AND Demonstrated knowledge of queries. _Preferred… more
- Ensono (Philadelphia, PA)
- …US Citizenship and pass related background checks including but not limited to Medicare and Medicaid and VA **Preferred Skills:** + Experience with secure file ... experience and a strong background in implementing and maintaining Centers for Medicare & Medicaid Services (CMS) security standards and compliance requirements. +… more
- WellSpan Health (Lebanon, PA)
- …members of the health care team. Primary responsibilities include identification of Medicare patients appropriate for Annual Wellness Visits (AWV) and execution of ... Functions:** + Review office schedules and identify patients appropriate and due for Medicare AWV. + Work collaboratively with clinical teams to accomplish AWV in an… more
- Prime Therapeutics (Harrisburg, PA)
- …Supports new client implementations + Supports all lines of business (commercial/HIM, Medicare and Medicaid) + Other duties as assigned **Education & Experience** + ... or within a highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) +...related area of study, such as Juris Doctor + Medicare Part D, Medicaid, and/or Affordable Care Act knowledge… more
- R1 RCM (Jenkintown, PA)
- …1 year of Healthcare revenue cycle experience (Follow Up, Billing, Cash Posting, Medicare HMO and Payor) required. + 3+ years of collections experience is preferred. ... extensive knowledge in the health insurance industry (Commercial Insurances, Medicare , Medicaid); health claims billing and/or Third-Party contracts, minimum of… more