- CVS Health (Tallahassee, FL)
- …clinical oversight of DSNP/MMP complex populations (Dual-Eligible Special Needs Plan / Medicare - Medicaid Plan) * Develop and lead clinical strategy and ... * Actively participate in meetings and communication with the State Department of Medicaid in person as needed. * Outward facing position to interact and collaborate… more
- Humana (Springfield, IL)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... facilities, ancillary providers, and/or FQHCs. + Experience working with Illinois Medicaid . + Experience in provider operations, building strong relationships with… more
- Queen's Health System (Honolulu, HI)
- …* Strong knowledge and understanding of different payor types (ie Medicare , Medicaid , Commercial, HMO, Workers' Compensation, No-Fault, Capitation, TPL, ... functions, including registration, cashiering and insurance verification. * Monitors the Medicaid /Quest pending and Large Dollar work queues to ensure coverage is… more
- Trinity Health (New Hampton, IA)
- …of insurance and governmental programs, regulations and application processes (eg, Medicare , Medicaid , Social Security Disability, Champus, Supplemental Security ... in seeking and applying for healthcare funding (eg, Charity Care, Medicaid , or other local/governmental funding program) and/or require assistance in reviewing… more
- Elevance Health (Nashville, TN)
- …Pharmacy Care Center (CPCC)** is a clinical pharmacy call center that services Medicare , Medicaid , and the Commercial member populations. The members we reach ... + PTCB certification preferred. + Experience communicating with and supporting Medicaid members preferred. + Call center experience with high call volumes… more
- Access: Supports For Living (Middletown, NY)
- …working knowledge of behavioral health billing in New York State, particularly regarding Medicare , Medicaid , Medicaid Managed Care, and Commercial Insurance. ... Key Responsibilities + Lead and supervise a billing team of up to 8 staff. + Manage all aspects of the revenue cycle, including billing systems, insurance verifications/authorizations, collections, and payment processes. + Maintain a clear understanding of… more
- Cardinal Health (Doral, FL)
- …of insurance claim processing and denial management preferred. + Familiarity with Medicare , Medicaid , and managed care preferred. + Proficiency in billing ... and increase cash flow for the organization. This position is a Medicaid insurance associate on the revenue cycle management team. **Responsibilities:** + Review… more
- RiseBoro Homecare Inc. (Brooklyn, NY)
- …base. This role requires a strong understanding of homecare regulations related to Medicare , Medicaid , and other insurance programs. The Intake Specialist will ... Home Health Aide Program (CHHA) and Managed Long-Term Care (MLTC), Medicaid , insurance verification, Maximus procedures, and MLTC enrollment. . Collaborate and… more
- Covenant Health Inc. (Knoxville, TN)
- …+ Demonstrates knowledge of State and Federal regulations, HCFA guidelines, HIPAA, Medicare / Medicaid guidelines and other Third Party Payor requirements assuring ... provides training for new or revised rules ensuring compliance with HCFA Tenncare/ Medicaid or other State or Federal regulations. + Resolves complex collection… more
- Henry Ford Health System (Troy, MI)
- …to investigate, analyze, and resolve issues at a high level. + Knowledge of Medicare , Medicaid , Medicaid OPPS reimbursement, and other third- party billing ... rules/coverage, preferred. + General understanding of the hospital revenue cycle. CERTIFICATIONS/LICENSURES REQUIRED: + Coding Credential (CPC, COC, CCA, CCS, RHIT) or Clinical Credential (RN, NP, PA) preferred. Additional Information + Organization: Corporate… more