- Highmark Health (Jefferson Hills, PA)
- …by policy/procedure. (25%) + Patient Population: + Outpatient Techs: Validates Medicaid, Medicare , or commercial insurance drug coverage and ensures adjudication ... _. In connection with this, all employees must_ _comply with_ _both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of… more
- Merck (North Wales, PA)
- …operations, project management, or reimbursement support * Strong knowledge of health insurance structures ( Medicare Part B, Medicaid, commercial) and related ... how the products are covered under the benefit design (Commercial, Medicare , Medicaid) * Answer questions about coverage, including payer-specific access questions… more
- Humana (Harrisburg, PA)
- …focused on continuously improving consumer experiences **Preferred Qualifications** + Health insurance experience + Medicare Advantage experience Travel: While ... paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 11-29-2025 **About us**… more
- Prime Therapeutics (Harrisburg, PA)
- …processes, and participates in committee review meetings within the Commercial, Medicare , Medicaid, and Health Insurance Marketplace for the assigned ... management experience related to, or within Pharmacy Benefit Management (PBM) or health insurance Must be eligible to work in the United States without the need… more
- CenterWell (Harrisburg, PA)
- …experience in a medical management review organization, such as Medicare Advantage,managedMedicaid, or Commercial health insurance . + Experience ... teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to… more
- Robert Half Office Team (Bethel Park, PA)
- …for consent forms and provide patients with required educational documents, such as Medicare or Tricare notices. * Verify insurance eligibility and input benefit ... role, you will handle critical tasks related to patient registration, insurance verification, and admissions while providing exceptional customer service. This is… more
- Cardinal Health (Harrisburg, PA)
- …company policy, regulations, or third party policy. + Updates patient files for insurance information, Medicare status, and other changes as necessary or ... things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities… more
- Penn Medicine (Philadelphia, PA)
- …maintaining the highest level of billing standards following current guidelines from Medicare , Medicaid, and other insurance entities. + Answering revenue cycle ... will be responsible for investigating claim denials and underpayments by insurance carriers and appeal for payment or make appropriate adjustment. Exercising… more
- Merck (Harrisburg, PA)
- …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
- CVS Health (Harrisburg, PA)
- …record systems and engaging on multiple platforms - Demonstrated understanding of insurance , Medicaid, Medicare billing requirements - Evidence of strong crisis ... intervention skills - Previous experience in a mental health clinic or hospital setting **Education** - Completed Master's degree program from an accredited College or University. - State License with one or more of the following licenses: Licensed Clinical… more