- Baylor Scott & White Health (Nashville, TN)
- **Description - External** **JOB SUMMARY** The Healthcare Billing Compliance Consultant Sr performs ongoing activities related to the development, implementation, ... a timely way. . Responds to inquiries and guidance requests utilizing applicable Medicare and Medicaid rules and regulations. Serves as a compliance resource to BSWH… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Care Quality and Manager (CHQM) * Registered Nurse * Solid knowledge of Medicare Advantage Business Compensation and Benefits : Pay Range: $88,600.00 - ... Shield of Minnesota Position Title: Quality & Risk Adjustment Provider Consultant Location: Hybrid | Eagan, Minnesota Career Area: Customer Service/Operations About… more
- Sedgwick (San Juan, PR)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Litigated Claims Consultant | Public Entity | Remote **Are you looking for an impactful job ... principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business. + Technically skilled… more
- Insight Global (Fort Worth, TX)
- …for pensions, annuities, investments and other sources - Social Security and Medicare Planning - Military and Federal Employee Benefits - Retirement planning ... Job Description The Advanced Planning Consultant services as a financial planning expert to...income taxation - IRA and Qualified Retirement Plan features benefits , distribution option and taxation rules - Strategies for… more
- Sedgwick (Houston, TX)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Litigation Consultant **PRIMARY PURPOSE** : To address and handle high end cases with ... principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business. + Technically skilled… more
- US Tech Solutions (RI)
- …and evaluates potential quality of care issues based on clinical policies and benefit determinations. + Considers all documented system information as well as any ... comprehensive knowledge of complex delegation arrangements, contracts, clinical criteria, benefit plan structure, regulatory requirements, company policy and other… more
- WellSense (MA)
- …You:** . Full-time remote work . Competitive salaries . Excellent benefits **Key Functions/Responsibilities:** + **Develops and enhances our physician, clinician, ... relations or network management required** + **Experience in the Medicare provider healthcare insurance industry preferred** **Certification or Conditions of… more
- Humana (Gainesville, FL)
- …responsible for the development, implementation and management oversight of the company's Medicare Stars Program in the Florida region. Ideal candidates will be ... is based upon company and/or individual performance. **Description of Benefits ** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers… more
- US Tech Solutions (May, OK)
- …evaluates potential quality of care issues based on clinical policies and benefit determinations. Considers all documented system information as well as any ... comprehensive knowledge of complex delegation arrangements, contracts ,clinical criteria, benefit plan structure, regulatory requirements, company policy and other… more
- CareFirst (Baltimore, MD)
- …aggressively pursues growth within groups by developing and implementing account specific benefit and financial strategies. + Manages and develops a set of assigned ... underwriting principles; group health/life insurance financial/funding mechanisms; stop loss, medicare advantage, wellness, clinical, managed care and point solutions,… more