- Aveanna Healthcare (PA)
- …of application + Valid CPR + Valid Drivers License and proof of automobile insurance Preferred: + Medicare Skilled Nursing experience + Basic understanding of ... 1-year RN experience in a health care setting As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all… more
- Humana (Harrisburg, PA)
- …benefits providers in the US. At the core of this evolution is Humana's Insurance Segment, which provides Medicare Advantage, Medicaid, and other health plans to ... millions. By integrating insurance with care delivery through CenterWell, Humana is improving...a pivotal role in defining the future of Humana's Medicare and Medicaid businesses, which generate the majority of… 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 ... right things done. **The Accounts Receivable Specialist is responsible for processing insurance claims and billing. They will work within the scope of… 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
- 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
- UPMC (Pittsburgh, PA)
- …effectively problem solve and make independent decisions. + Know insurance pre-certification/pre-authorization, Managed Care, Medicare /Medicaid and Commercial ... insurance plans. + Prior working experience on personal computers and various office equipment. Licensure, Certifications, and Clearances: + ACT 34UPMC is an Equal Opportunity Employer/Disability/Veteran more
- Humana (Harrisburg, PA)
- …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
- Philips (Philadelphia, PA)
- …and presenting clinical evidence to physicians. + Being an expert on Medicare , Medicaid and private insurance coverage-criteria for InCourage vest therapy, ... while effectively educating healthcare teams in identifying patients who meet coverage criteria. Obtaining medical record documentation in order for coverage to be obtained. + Analyzing data to effectively target priority healthcare teams and create sales call… more
- UPMC (Pittsburgh, PA)
- …providers of the UPMC Health Plan. A general understanding of Health care insurance and Medicare managed care is highly preferred for this position, ... **Responsibilities:** + Develop and maintain collaborative relationships with assigned providers/practices within the UPMC Health Plan Network. + Coordinate and present education of providers/practices related to risk adjustment, coding, and clinical… more
- CVS Health (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
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