- Baystate Health (Springfield, MA)
- …variety of grant and/or government sponsored programs, identifying and counseling Medicare patients without secondary insurance , assisting with applications for ... and outpatient settings. These services include walking patients through state-wide insurance and grant program options, certified assitance in application process,… more
- Merck (Boston, MA)
- …operations, project management, or reimbursement support * Strong knowledge of health insurance structures ( Medicare Part B, Medicaid, commercial) and related ... Available benefits include medical, dental, vision healthcare and other insurance benefits (for employee and family), retirement benefits, including 401(k),… more
- Tufts Medicine (Boston, MA)
- …(Word, Excel, PowerPoint). 8. Payor knowledge, along with the ability to navigate Medicare , Medicaid and commercial insurance plans to assist with the intake ... benefit and authorization process. At Tufts Medicine, we want every individual to feel valued for the skills and experience they bring. Our compensation philosophy is designed to offer fair, competitive pay that attracts, retains, and motivates highly talented… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …billing systems, and compliance preferred. + Basic knowledge of CMS, Medicare , Medicaid, and commercial insurance billing principles preferred. **KNOWLEDGE, ... SKILLS, AND ABILITIES REQUIRED:** + Strong understanding of accounting, retail operations, and DME regulatory requirements. + Excellent financial management and analytical skills. + Proven leadership and team management abilities. + Strong communication and… more
- Fallon Health (Worcester, MA)
- …hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive ... SLA's. With speed, accuracy, and integrity, ensures that enrollee data for Medicare Advantage, Medicare Supplement, NaviCare, Summit Elder Care, Fallon Health… more
- Humana (Boston, MA)
- …Utilization management experience in a medical management review organization, such as Medicare Advantage, Managed Medicaid, or Commercial health insurance . + ... internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to… more
- Fallon Health (Barnstable, MA)
- …hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive ... Program policies and processes o Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing member education, outreach, and actions in… more
- CenterWell (Boston, MA)
- …Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare + Current ... paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-25-2025 **About us**… more
- Humana (Boston, MA)
- …of the responsibilities: + Engage with the producers and the Center for Medicare and Medicaid Services/Department of Insurance regulations specific to them if ... the general ledger. + Analyze and interpret Center for Medicare and Medicaid Services and Department of Insurance... Medicare and Medicaid Services and Department of Insurance regulations to establish required appointment fees for producers… more
- Humana (Boston, MA)
- …Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance . + ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical… more