- Intermountain Health (Phoenix, AZ)
- …CPT codes and specific payer types. + Coordinates all aspects of provider enrollment with commercial and government ( Medicare and Medicaid) professional fee ... and professional fee claim reimbursement. 2. Coordinates all aspects of provider enrollment with Intermountain Health's commercial and government ( Medicare and… more
- Molina Healthcare (Green Bay, WI)
- …equivalent combination of education and experience **Required Experience** 5-7 years Enrollment -related experience in Managed care or Medicare setting ... or equivalent combination of education and experience **Preferred Experience** 7-9 years Enrollment -related experience in Managed care or Medicare setting To all… more
- Fallon Health (Springfield, MA)
- …in our service area, and who have MassHealth Standard, and may have Medicare . It combines MassHealth (Medicaid) and Medicare benefits, including prescription ... to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE- in the region. **Brief summary of purpose:**… more
- MVP Health Care (Schenectady, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a ** Medicare Field Sales Representative** to join #TeamMVP. This is the opportunity for ... multi-cultural environment. Must be sensitive to the needs of Medicare -eligible populations, including individuals with chronic conditions and disabilities. +… more
- Prime Therapeutics (Harrisburg, PA)
- …our passion and drives every decision we make. **Job Posting Title** Mgr Medicare Part D Pharmacy Programs - Remote, Pennsylvania **Job Description** Manages the ... coordination of benefits in the pharmacy program with Medicare Part D plans. Provides the technical and leadership...include but are not limited to premium amounts, late enrollment penalties, and reimbursement of drug claims. + Ensures… more
- East Boston Neighborhood Health Center (Revere, MA)
- …our Careers Page (http://careers.ebnhc.org) . Time Type: Full time Department: PACE Enrollment and Eligibility All Locations: 300 Ocean Avenue - Revere Position ... direction of the Neighborhood PACE Business Office Supervisor, the Enrollment and Eligibility Specialist will be responsible for the...of MassHealth eligibility + Strong knowledge of the overall Medicare eligibility of Part A, B and D +… more
- Healthfirst (FL)
- …work experience in Managed Care Health Insurance Plan + Experience with appeals for Medicare , Medicaid, Dual enrollment and commercial Plans end to end. + Claims ... processing experience with coding criteria is preferred. This includes the auto forwarding of upheld cases to the respective regulatory independent reviewer for denied cases. **Preferred Qualifications** + Bachelors degree from an accredited institution or… more
- AmeriHealth Caritas (Philadelphia, PA)
- **Role Overview:** The Medicare Broker Relations Manager drives broker channel growth and ensures sales success. This position is responsible for cultivating and ... brokers and general agencies, while ensuring full compliance with Centers for Medicare & Medicaid Services (CMS), state, and internal regulations. This highly… more
- Molina Healthcare (Scottsdale, AZ)
- …follow, and you keep complaint data synchronized across appeals & grievances, enrollment , claims, pharmacy, and quality functions. You surface systemic issues, steer ... Compliance Mastery * Track record coordinating cross-functional action plans with Enrollment , Claims, Pharmacy, Network, and Member Services * Hands-on experience… more
- Healthfirst (NY)
- **Duties and Responsibilities:** + Oversee the enrollment process, ensuring timely and accurate processing of new and modified enrollments, renewals, and ... integrity and address discrepancies related to member eligibility and enrollment . + Manage premium billing cycles, invoice generation, and...and Knowledge of NY lines of business such as Medicare NY, Medicaid, Child Health Plus, QHP, EP, HARP… more