- Fairview Health Services (Hibbing, MN)
- …cost-effective manner. + Ensuring documentation is accurate, timely, and compliant with Medicare / Medicaid , State, TJC and agency standards. + Monitoring patient ... of call each month. _Internal Posting:_ 10/26/25 **About this facility** + Medicare Certified Agency + Care team includes RNs, Physical Therapists, Occupational… more
- US Tech Solutions (May, OK)
- …HAVE MEDCOMPASS or ASSURECARE exp. . MUST HAVE MANAGED CARE exp and Medicare / Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management ... of Care cases across all lines of business (Commercial and Medicare ). . Independently coordinates the clinical resolution with internal/external clinician support… more
- US Tech Solutions (RI)
- …HAVE MEDCOMPASS or ASSURECARE exp. + MUST HAVE MANAGED CARE exp and Medicare / Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management ... review. + MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST HAVE 6 months of Prior Authorization. **Education:** + RN with current unrestricted state licensure **About US Tech Solutions:** US Tech Solutions is a global… more
- Sodus Rehab & Nursing Center (Medina, NY)
- …+ Participates in internal audits as directed + Possess a strong knowledge of Medicare , Medicaid and other payment sources and their responsibility in the SNF ... resident, staff and family education and in-servicing + Demonstrates working knowledge of Medicare Part A PPS case management + Complies with Federal and State… more
- Humana (San Juan, PR)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... + Call center or triage experience + Previous experience managing Medicare members **Work-At-Home Requirements** To ensure Home or Hybrid Home/Office employees'… more
- Bozeman Health (Bozeman, MT)
- …Balance Analyst is responsible for processing refunds for third party insurance, Medicare , Medicaid , and Government-Assisted Programs; for both hospital and ... of medical billing experience in a hospital setting. + Intermediate knowledge of Medicare billing. Essential Job Functions: In addition to the essential functions of… more
- Fairview Health Services (Hibbing, MN)
- …Experience in inpatient, outpatient, and home-based palliative care. + Knowledge of Medicare / Medicaid hospice regulations. + Experience in a medical director ... with regulations. + Conducts face-to-face encounters for recertifications as required by Medicare . + Serves as a liaison between the hospice team, attending… more
- United Therapeutics (IL)
- …Teams + Advanced knowledge of medical insurance terminology + Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in ... Medicare (Part B and Part D) Job Location This position will require candidates to live within the assigned territory. This includes North Dakota, South Dakota,… more
- Houston Methodist (The Woodlands, TX)
- …focus and application of positive language principles + Comprehensive knowledge of Medicare , Medicaid and Managed Care requirements + Comprehensive knowledge of ... if needed, and informs management of the possible need for issuing Medicare Hospital Initiated Notice of Non-coverage. + Applies approved utilization criteria to… more
- Health Care Service Corporation (Albuquerque, NM)
- …criticism + Experience in the Agile methodology + Good understanding of Medicare / Medicaid Healthcare data + Demonstrate mentality of building well architected ... Experience in Healthcare Claim or Enrollment functions. + Experience supporting Medicare technology platforms \#INCR \#LI-BS1 \#LI-Hybrid **Are you being referred to… more