- US Tech Solutions (May, OK)
- …based on clinical criteria and plan design. Includes verifying insurance coverage and eligibility, interpreting clinical guideline criteria, consulting physicians ... Benefits Manager (PBM) **Skills:** + MUST HAVE MANAGED CARE exp and Medicare /Medicaid knowledge. + MUST HAVE 6 months of experienced with Prior… more
- Dignity Health (Santa Maria, CA)
- …patient would benefit from home care or hospice services and/or 2) explain Medicare and Medicaid guidelines, insurance plan benefits, financing options, CHI ... to company policy. CRE II Basic knowledge of the healthcare industry, Medicare , managed care, insurance reimbursement and accounting practices. Knowledge of… more
- Providence (Beaverton, OR)
- …them.** **Providence Health Plan is calling a Clinical Program Coordinator RN, Medicare / Medicaid who will:** + Provide care coordination, case management and ... Audits, Appeals or Delegation) + Experience working in a health plan, medical insurance plan or another similar work environment + Current nursing experience in the… more
- BlueCross BlueShield of North Carolina (NC)
- …impact patient outcomes and business performance-whether it's designing innovative insurance products, optimizing pricing strategies, or evaluating advanced care ... 9 years of relevant actuarial experience. **Bonus Points** + Experience in Medicare Advantage Risk Adjustment highly preferred **What You'll Get** + The opportunity… more
- University of Miami (Doral, FL)
- …Advance Directives, HIPAA, No Surprise Billing, Good Faith Estimate, Off Campus Medicare Co- insurance , ABNs, and MSPQ, prior to services being rendered. ... Contacts patients' families or physicians' offices to obtain missing insurance information. + Verifies insurance and confirms...to obtain missing insurance information. + Verifies insurance and confirms insurance eligibility of patient… more
- University of Utah (Salt Lake City, UT)
- …preferred. Certain positions may require familiarity with hospital billing systems, Medicare and insurance reimbursement regulations, etc. Applicants must ... + **Flex spending accounts** + University provided**basic employee life insurance **coverage equal to a salary of up to $25,000...a salary of up to $25,000 + Variety of elective** insurance coverage**, including life insurance , short and… more
- Highmark Health (Montgomery, AL)
- …experience in managed care pharmacy + 2 years of clinical account management experience in Medicare as part of the 4 year managed care experience + 2 years of ... times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of… more
- Centene Corporation (New York, NY)
- …auditing, project management, or business analysis experience, preferably within the Medicare field. Previous experience coordinating cross functional teams on large ... Centene offers a comprehensive benefits package including: competitive pay, health insurance , 401K and stock purchase plans, tuition reimbursement, paid time off… more
- Care Initiatives (Waterloo, IA)
- …office functions, including Accounts Receivable (AR), Accounts Payable (AP), resident billing, Medicare /Medicaid , and insurance claims . + Maintain accurate ... and collections in a healthcare or long-term care setting. + Familiarity with Medicare , Medicaid, and insurance reimbursement processes . + Strong organizational… more
- WesleyLife (Johnston, IA)
- …billing regulations and implement necessary process changes for compliance. + Understand Medicare and Commercial Insurance for co- insurance calculations, ... cash posting, and collections. + Handle delinquent accounts and resolve credit balances. + Maintain confidentiality of client and organizational information. + Collaborate with various stakeholders including providers, finance staff, auditors, and state… more