- Guidehouse (Birmingham, AL)
- …orders for completion and ensures all required information is listed. + Completes Medicare Compliance and obtains ABN if necessary. + Knowledge of all ... Federal, State and Local Laws pertaining to insurance rules and regulations. + Utilizes multiple computer systems. + Maintains positive customer service at all times, referring unresolved issues to appropriate supervisor. + Answers telephone calls. Follows… more
- US Physical Therapy (York, PA)
- …Previous outpatient orthopedic clinic experience + Exercise and Manual based skills, Medicare compliance responsibilities and Sports Rehab + Outgoing and ... energetic personality **Additional Information** + Great hourly compensation + 401k + Multiple opportunities for Professional Development, Specialization, and Leadership + Family-Friendly Work Environment + Investment from a company that wants you to succeed… more
- Highmark Health (Charleston, WV)
- …models. This job is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, hands-on, office ... based support to PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies opportunities for improvement in value… more
- The Cigna Group (Bloomfield, CT)
- …position will provide external actuarial analytics support within the regulated Medicare market and Pharmacy Benefit Manager (PBM) Healthplan space. This actuarial ... a designated full time support to Express-Script's external client's Medicare Part D business. This role will matrix with...Bid Development, Desk Review & Audits + CMS Regulatory Compliance / Reporting + Financial Reconciliation Modeling + Trend… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …with the guidance and plans they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and Medicare Line of Business, ... explaining program benefits in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and regulations. The Medicare… more
- Masonicare (Wallingford, CT)
- …the planning, development and implementation of a comprehensive care plan. 4. Oversees compliance with Medicare Certifications for all Medicare A / ... patients/residents on the designated units. 5. Regularly prepares and distributes Medicare Notices for patients/residents on the designated units. + Communicates… more
- US Tech Solutions (May, OK)
- …company by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, ... As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related...and ensuring accurate decisions that comply with compendia and Medicare guidance and timelines. This is a great opportunity… more
- US Tech Solutions (AZ)
- …company by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, ... As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related...and ensuring accurate decisions that comply with compendia and Medicare guidance and timelines. This is a great opportunity… more
- Robert Half Accountemps (Duarte, CA)
- …reimbursements. * Maintain comprehensive and accurate patient billing records in compliance with Medicare , Medi-Cal, and payer-specific requirements. * Follow ... and appeals. * Strong knowledge of billing regulations and compliance standards set by Centers for Medicare ...and compliance standards set by Centers for Medicare & Medicaid Services (CMS). * Experience with hospital… more
- Prime Therapeutics (Pierre, SD)
- …analytical skills **Preferred Qualifications** + PBM/health care experience related to Medicare , Medicaid, Commercial, HIM + Certified Compliance and Ethics ... passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Risk Assessment and Oversight) - Remote **Job Description** The Senior… more