- SUNY Upstate Medical University (Syracuse, NY)
- …of certification must be consistent with practice). Must have NPI number and be Medicare Enrolled with Medicare Identification Number (or PTAN) OR be eligible ... for Medicare Enrollment within 6 months of hire (eligibility criteria...medical malpractice insurance, National Certification through ANCC and be Medicare enrolled with Medicare Identification Number (or… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …timely, and complete clinical quality reporting across multiple programs including Medicare CQMs, HEDIS, Stars, and Commercial payer quality initiatives. This role ... documentation in structured data fields within their EMRs to meet Medicare and Commercial payer quality reporting requirements. + Facilitates the generation,… more
- Molina Healthcare (Las Cruces, NM)
- …is primarily in the Medicaid space, however, will cross over to Marketplace and Medicare . This role will lead by example, working alongside their team. There may be ... Demonstrates thorough understanding of Molina's product lines, Medicaid, CHIP, Medicare SNP, Marketplace, MMP, etc **JOB QUALIFICATIONS** **REQUIRED EDUCATION:**… more
- Highmark Health (Camp Hill, PA)
- …budgetary responsibility and authority. + As a seasoned Group Retiree market expert ( Medicare Advantage, Medicare Supplement, Part D, Medicare Exchanges) ... Continuously monitor and maintain knowledge of the Commercial, Group Retiree and Medicare markets and competition. + Develop strategies and tactics to optimize… more
- Covenant Health Inc. (Knoxville, TN)
- …leading Covenant Health's reimbursement strategy across all payors, including Medicare , Medicaid/TennCare, and commercial insurers. This role ensures accurate ... operations and financial performance. Recruiter: Suzie Mcguinn || ###@covhlth.com Responsibilities Medicare & Medicaid Reimbursement Oversight + Lead all phases of … more
- Always Best Care Senior Services (Honolulu, HI)
- …services. We are looking for a Home Health Administrator with expertise in Medicare compliance, billing, and coding to ensure our agency operates smoothly and in ... difference, we'd love to meet you! Key Responsibilities * Ensure compliance with Medicare guidelines for Home Health services. * Prepare, submit, and track … more
- Medical Mutual of Ohio (OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Supports corporate and ... lifecycle processes for all lines of business (Commercial, Marketplace, Medicare Advantage, and Medicaid), including HEDIS audit submission, Consumer Assessment… more
- New York State Civil Service (Staten Island, NY)
- …individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or Federally assisted program). ... appointed, you may be required to become an enrolled Medicare provider; obtain and provide to your employer a...to allow for your services to be billed through Medicare and Medicaid. If you are appointed and you… more
- Ventura County (Ventura, CA)
- …for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare , and general insurance reimbursement requirements. The ideal candidate possesses ... medical billing or a related field. + Experience in Managed Care/Medicaid/ Medicare and/or Commercial Insurance billing. + Experience with multiple Electronic Health… more
- The Cigna Group (St. Louis, MO)
- **Product Management Senior Advisor - Medicare Solutions, Express Scripts** **Description of Position:** + The Product Management Senior Advisor provides leadership ... will ensure their capabilities are compliant with the Center for Medicare and Medicaid Services (CMS) regulations, lead implementation of enhancements, provide… more