• Audit & Reimbursement III (US)

    Elevance Health (Winston Salem, NC)
    …member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services ... judgment and experience. + May perform Part A provider enrollment responsibilities as needed. + Associates in this role...a minimum of 5 years of audit/reimbursement or related Medicare experience; or any combination of education and experience,… more
    Elevance Health (09/24/25)
    - Related Jobs
  • Patient Assistance Counselor

    Marshfield Clinic (Weston, WI)
    …federal and pharmaceutical programs and Foundation grants, and assists with outreach and enrollment to bridge patients with these resources. This position is on site ... months of hire. + Certified Application Counselor designation through the Centers for Medicare and Medicaid Services within three months from the first fall training… more
    Marshfield Clinic (09/23/25)
    - Related Jobs
  • Billing & Reconciliation Representative

    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 ... of account status updates. Responsibilities include correcting discrepancies related to enrollment and cash posting within the billing process and preparing… more
    Humana (09/13/25)
    - Related Jobs
  • Senior Consumer Service Operations Professional

    Humana (Frankfort, KY)
    …implementation, client support, client services, client administration, customer service, enrollment and eligibility, claims processing, and call center operations. ... working in healthcare industry + **2+ years experience with Employer/Group Medicare plans** + Extensive experience in a corporate service operations environment… more
    Humana (09/06/25)
    - Related Jobs
  • Pharmacy Help Desk Associate

    Staffing Solutions Organization (Augusta, ME)
    …and technicians representing various coverage plans + Educate MaineCare Members regarding various Medicare Part D plans and how to choose a plan, how the plan ... pays benefits, etc. + Educate MaineCare Members on Medicare Savings Program/ Medicare buy-in plans and how...plan pays benefits, etc. + Assist MaineCare Members with enrollment processes. + Review insurance coverage for pharmacies, doctor's… more
    Staffing Solutions Organization (08/21/25)
    - Related Jobs
  • Utilization Review Manager

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …compliance to regulatory and health plan requirements for authorization, including Medicare Inpatient Only List and communicates to provider to obtain accurate ... ensure patient class determinations * Serves as expert resource for all Medicare Notification Letters and ensures appropriate distribution of all letters (IMM, MOON,… more
    Minnesota Visiting Nurse Agency (08/08/25)
    - Related Jobs
  • Credentialing Specialist

    Robert Half Office Team (Greenwood Village, CO)
    Description Credentialing Specialist ( Enrollment Specialist) Position Overview: We are seeking a detail-oriented and organized Credentialing Specialist ( ... Enrollment Specialist) to join our team. In this role,...the healthcare industry is strongly preferred. + Familiarity with Medicare and Medicaid processes. + Minimum of one year… more
    Robert Half Office Team (09/24/25)
    - Related Jobs
  • AVP, Health Plan Operations (Connecticut)

    Molina Healthcare (Hartford, CT)
    …position plans, organizes, staffs, and coordinates the operations of state Medicaid, Medicare and Marketplace Health Plan operations. * Works with staff and senior ... for MHI Service Operations, including: Claims, Configuration Information Management, Enrollment , Contact Center Operations, IT, Provider Configuration Management, Program… more
    Molina Healthcare (09/23/25)
    - Related Jobs
  • Distribution Mail Room Services Rep II

    Fallon Health (Worcester, MA)
    …integrated care for our members with a special focus on those who qualify for Medicare and Medicaid. We also serve as a provider of care through our Program of ... limited to filing, photocopying, mailing of correspondence, research, batching enrollment applications and computer look-up. Ensures that services provided… more
    Fallon Health (09/06/25)
    - Related Jobs
  • Reconciliation Analyst

    Convey Health Solutions (Fort Lauderdale, FL)
    …+ Daily OHI/COB Rejections + Monthly review and preparation of the CMS Enrollment Data Validation file and submissions + Working understanding of Centers for ... Medicare & Medicaid Services (CMS) guidance + Conform with...or other entities as permitted to complete processing of enrollment , disenrollment, billing and or reconciliation transactions + Make… more
    Convey Health Solutions (09/03/25)
    - Related Jobs