- Mayo Clinic (Phoenix, AZ)
- …customer service. Must be able to work independently as needed. Knowledge of Medicare , Medicaid and/or private insurance billed preferred with attention to ... Competitive retirement package to secure your future. **Responsibilities** The HME Specialist I position is the first of multiple career opportunities within… more
- Molina Healthcare (Phoenix, AZ)
- …to determine if providers have sanctions/exclusions. * Reviews and processes daily alerts for Medicare Opt-Out reports to determine if any provider has opted out of ... Medicare . * Reviews and processes daily NPDB Continuous Query...systems. * Experience with professional written and verbal communication. ** Preferred Experience:** Experience in the health care industry To… more
- Molina Healthcare (Chandler, AZ)
- …in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Enters denials and ... communication skills. * Microsoft Office suite/applicable software program(s) proficiency. ** Preferred Qualifications** * Customer/provider experience in a managed care… more
- Molina Healthcare (AZ)
- …Directory (including ongoing execution, QA and maintenance of supporting tables), Medicare Provider Directory preparation, and FQHC/RHC reports. + Generates other ... codes, etc. + Access and Excel - intermediate skill level (or higher) ** Preferred Education** Bachelor's Degree ** Preferred Experience** + 5+ years managed care… more
- Molina Healthcare (AZ)
- …tools such as Department of Health and Human Services (DSHS) and Medicare billing guidelines, Molina claims processing policies and procedures, and other resources ... * Microsoft Office suite and applicable software programs proficiency. ** Preferred Qualifications** * Claims recovery experience. * Health insurance experience… more
- Molina Healthcare (Mesa, AZ)
- …administration of contracts with State and/or Federal governments for Medicaid, Medicare , Marketplace, and other government-sponsored programs to provide health care ... (or similar reporting tools), SQL query, MS Access, and MS Excel. ** Preferred Education** Bachelor's Degree in Business Administration, Healthcare, or related field.… more
- Molina Healthcare (Mesa, AZ)
- …Certification, Association** + AAPC Certified Medical CPC, CPMA, CPCO or similar specialist preferred + Certified Fraud Examiner and/or AHFI professional ... oral and written communication skills and presentation skills. + Medicare and Marketplace experience **JOB QUALIFICATIONS** **Required Education** High School… more
- CenterWell (Phoenix, AZ)
- …Provider Number + Minimum of three to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with ... + Oversee daily operations of physician services. + Build strong relationship with specialist , hospitalist, SNF and other providers to form a narrow network of… more
- CenterWell (Phoenix, AZ)
- …advanced practice professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist , Quality based Coder, Referral Coordinator and more. Our approach allows ... Qualifications:** + Minimum of two to five years directly applicable experience preferred + Successful completion of a Nurse Practitioner program with Board… more
- Banner Health (Mesa, AZ)
- …measures better than the national and Arizona average in almost all Medicare Quality Compare patient satisfaction results. POSITION SUMMARY This position evaluates ... and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health… more