- Cardinal Health (Harrisburg, PA)
- …about long and short-range changes in the reimbursement environment including Medicare , Medicaid, Managed Care, and Commercial medical and pharmacy plans while ... High School diploma or equivalent preferred + Knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- Cardinal Health (Harrisburg, PA)
- …a call center or customer service environment, preferred + Clear knowledge of Medicare , Medicaid & Commercial payer policies and guidelines for coverage, preferred + ... Knowledge of Diagnostic Medical Expense and Medicare Administrative Contractor practices, preferred + Clear understanding of...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- Penn Medicine (Lancaster, PA)
- …and procedures. + Completes mandatory education and training that includes review of age-specific needs, caring behaviors, and interpersonal skills as defined ... + A health care provider in good standing with Medicare , Medicaid, and other federal and state health insurance...health insurance programs, ie not excluded from participation in Medicare , Medicaid or any other federal or state health… more
- Humana (Harrisburg, PA)
- …residence + Eligibility to participate in federal prescription programs (eg, Medicare /Medicaid) + Self-directed with the ability to work effectively both ... + Experience in managed care pharmacy, particularly in utilization management review **Additional Information:** **Interview Format** : As part of our… more
- Robert Half Accountemps (Mars, PA)
- …and patient services. Prepare and submit claims to insurance companies, Medicare , and Medicaid as applicable. Payment Posting: Accurately enter payments received ... accounts receivable status, payment trends, and delinquent accounts for management review . Customer and Client Communication: Respond to patient or payer inquiries… more
- CVS Health (Harrisburg, PA)
- …to identify and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... of 1 year recent and related experience in medical record documentation review , diagnosis coding, and/or auditing. + Completion of AAPC/AHIMA training program for… more
- Humana (Harrisburg, PA)
- …Prior experience in provider education + Strong knowledge of medical record review + Understanding of billing, claims submission, and related processes + Proficient ... is higher. **Preferred Qualifications** + Bachelor's Degree + Previous experience in Medicare Advantage or Value-Based Care + AAPC CRC (Certified Risk Adjustment)… more
- CenterWell (Harrisburg, PA)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare + Current nursing experience in Hospital, SNF,… more
- Penn Medicine (Lancaster, PA)
- …and procedures. + Completes mandatory education and training that includes review of age-specific needs, caring behaviors, and interpersonal skills as defined ... + A health care provider in good standing with Medicare , Medicaid, and other federal and state health insurance...health insurance programs, ie not excluded from participation in Medicare , Medicaid or any other federal or state health… more
- Penn Medicine (Lancaster, PA)
- …and procedures. + Completes mandatory education and training that includes review of age-specific needs, caring behaviors, and interpersonal skills as defined ... + A health care provider in good standing with Medicare , Medicaid, and other federal and state health insurance...health insurance programs, ie not excluded from participation in Medicare , Medicaid or any other federal or state health… more