- Humana (Tallahassee, FL)
- …Provider Contracting Professionals who will be responsible for the Direct Agreements ( Medicare HMO and Medicaid). The Manager, Provider Contracting will lead a team ... arena + Proven contract preparation skills, with an in-depth knowledge of Medicare and other reimbursement methodologies + Excellent written and verbal communication… more
- Cognizant (Las Vegas, NV)
- …in Azure Kubernetes Services and Azure Catalogue with a strong background in Medicare and Medicaid Claims. This role requires a hybrid work model with occasional ... Azure Catalogue into existing systems ensuring seamless operations. + Analyze Medicare and Medicaid Claims processes to identify opportunities for cloud-based… more
- Elderwood (Grand Island, NY)
- …Act requirements, facility philosophy, and operational policies while maintaining compliance with other government agency laws and regulations. + Communicates ... + Supervise all admissions and readmissions for eligibility or denial of Medicare Skilled services regulations. + Notify all providers, in writing, within 24… more
- UCLA Health (Los Angeles, CA)
- …including CMS regulations, Department of Financial Responsibility provisions, Medicare Advantage Plan requirements, policies and procedures, and internal ... guidelines. You will also compile and maintain statistical data and ensure compliance with production and quality standards in accordance with department policy.… more
- CenterWell (Pinellas Park, FL)
- …Medicine or Geriatric Medicine preferred . Active and unrestricted DEA license . Medicare Provider Number . Minimum of two to five years directly applicable ... experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Cognizant (Blaine, MN)
- …technical issues related to OnBase applications to minimize downtime. + Ensure compliance with industry standards and regulations in Medicare and Medicaid ... of expertise in OnBase technologies and domain skills in Medicare and Medicaid Claims. The ideal candidate will work...Enabler Workview API and Workflow. . Demonstrate expertise in Medicare and Medicaid Claims Claims and Payer domains. .… more
- Houston Methodist (Houston, TX)
- …with the patient or patient guardian/representative. Ensures all Centers for Medicare & Medicaid Services (CMS) regulatory items are completed properly, including ... Medicare Secondary Payer Questionnaire (MSPQ). + Responds promptly to...personal information. Adheres to all Payment Card Industry (PCI) compliance regulations. + Organizes time effectively, minimizing incidental overtime,… more
- Adecco US, Inc. (Irving, TX)
- …trainings, and educational training venues. Must have a solid working knowledge of Medicare and Commercial insurance plans and benefit structures in order to relay ... readiness and adoption. 7. Serve as a subject matter expert on Medicare and commercial payer structures, translating complex benefit data into actionable insights… more
- Highmark Health (Harrisburg, PA)
- …and 3 years' experience in Acute or Managed Care/ experience with Medicaid or Medicare populations. OR + Bachelor's degree in Social Work with five years' experience ... in Acute or Managed Care/ experience with Medicaid or Medicare populations **Preferred** + Experience working with high-risk pregnant women OR experience working… more
- Humana (Miramar, FL)
- …discrepancies between company records and those maintained by the Centers for Medicare and Medicaid Services. This role encompasses a range of moderately complex ... supervision, while effectively managing multiple priorities. + Familiarity with Centers for Medicare and Medicaid Services (CMS) regulations is preferred. + Must be… more