- Starfish Family Services, Inc. (Livonia, MI)
- …programs, eligibility requirements, and the continuum of care. + Knowledge of Medicaid, Medicare , and private insurance billing processes. + Ability to analyze ... and Receptionists, ensuring excellent customer service, efficient scheduling, accurate insurance verification, and compliance with agency and regulatory requirements.… more
- Humana (San Juan, PR)
- …represents Humana by addressing incoming telephone, digital, or written inquiries from Medicare members. The Call Center Representative 2 strives to provide the ... applying to other Humana opportunities outside of Individual or Group Medicare . **Required Qualifications** + **Must** **currently** **reside in Puerto Rico.** +… more
- Humana (Concord, NH)
- …a part of our caring community and help us put health first** Individual Medicare Advantage (iMA) Rapid Solutions owns the MA Pricing Model (web app hydrated via ... annual pricing of Humana's largest segment of business, individual plan Medicare Advantage. The team consists of actuaries and business technology professionals… more
- Centene Corporation (Charleston, WV)
- …ASA designation and are looking to continue growing their actuarial career in ** Medicare financial forecasting, actuarial analyses, and bid support** . **ASA or FSA ... preferred for bid certification eligibility. **Position Purpose:** Produce quarterly Medicare financial forecasts. Conduct analysis, pricing and risk assessment to… more
- Centene Corporation (Trenton, NJ)
- …Purpose:** Responsible for the growth and performance of the assigned Medicare region to meet membership, pre-tax earnings, quality, network performance, provider ... and external stakeholders to become a thought leader in support of the Medicare product in the local market communities. + Identify the appropriate strategic… more
- Guidehouse (San Marcos, CA)
- …Job Functions** + Hospital Claims + Account Review + Appeals & Denials + Medicare /Medicaid + Insurance Follow-up + Customer Service + Billing + UB-04 **Duties ... **:** None **Clearance Required** **:** None **What You Will Do** **:** The ** Insurance Patient Account Representative - Hospital A/R Emphasis** is an extension of a… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National Committee for ... current NYS DOH, CMS regulations and standards if managing members of Medicare programs, and other regulatory requirements as applicable. + Carries out job… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …your true colors to blue. The Role The Clinical Pharmacist, Medicare Clinical Programs is responsible for providing comprehensive medication management services ... support care management with identifying and resolving drug-related problems for Medicare members. The Clinical Pharmacist will assist the Pharmacy Department in… more
- Centene Corporation (Clayton, MO)
- …will provide Executive Assistant support to the Chief Executive Officer of Medicare leader. Responsible for leading and providing executive level support for the ... Chief Executive Officer of Medicare in partnership with multiple internal partners to ensure...offers a comprehensive benefits package including: competitive pay, health insurance , 401K and stock purchase plans, tuition reimbursement, paid… more
- Elevance Health (AR)
- Provider Network Management Director ( Medicare Network Build) JR167138 **Preferred Location** : Commuting distance to the Little Rock, Arkansas office. **Hybrid 2:** ... Primary focus of this role is contracting and negotiating contract terms for ** Medicare , Medicaid,** and **ACA programs** . Deals with primarily the most complex… more