- Staffing Solutions Organization (Albany, NY)
- …is a reflection of our clients and the people they serve. **Program Support Specialist ** **Location - Albany, NY** **(50% in Office & 50% Remote)** **Duties:** This ... data + Assist with monitoring the Bureau's Mail Log **Desired Characteristics:** Preferred candidates will have strong analytical skills and the ability to pay… more
- Beth Israel Lahey Health (Burlington, MA)
- …line with payer expectations, contributing to favorable revenue cycle. The Operational Specialist position will have an impact on provider, patient, and staff ... insurance authorizations as needed. . Identifies potential payment issues with Medicare and other payers and communicates and/or resolves issues as appropriate… more
- Cardinal Health (Nashville, TN)
- …and procedures commonly used in a call center or customer service environment, preferred + Clear knowledge of Medicare , Medicaid & Commercial payer policies ... coverage, preferred + Knowledge of Diagnostic Medical Expense and Medicare Administrative Contractor practices, preferred + Clear understanding of Medical,… more
- Highmark Health (Buffalo, NY)
- …outcomes as a result of workflow transformation, superior coding accuracy, and Medicare STARS gap closure to providers based upon each individual gain/risk share ... for superior coding accuracy, cost and utilization reports, medical loss ratio reports, Medicare STARS gaps and other risk revenue opportunities. + Function as the… more
- Molina Healthcare (Salt Lake City, UT)
- …Preferred Experience** 2+ years compliance related experience. 1+ years in Medicare . ** Preferred License, Certification, Association** N/A To all current ... administration of contracts with State and/or Federal governments for Medicaid, Medicare , Marketplace, and other government-sponsored programs to provide health care… more
- Highmark Health (Montpelier, VT)
- …share and risk share models and will be implemented for the Organization's Medicare Advantage, Medicaid, ACA, and commercial populations with the goal of maximizing ... interpretation, and outcomes strategic plan development. + 1 year experience with Medicare STARS, Medicaid HEDIS, risk revenue value streams, and population health… more
- Brockton Hospital (Brockton, MA)
- …profiling, and reimbursement. + Knowledge of pathophysiology and disease process; Medicare Part A and B knowledge of regulatory environment. + Understanding ... and ability to communicate the differences between Medicare Part A and Part B guidelines and how...Excel, EMR, and experience with 3M 360 and Meditech preferred Other: Knowledge of Official Coding guidelines preferred… more
- Molina Healthcare (Roswell, NM)
- New Mexico residency preferred . Candidates who do not live in New Mexico must be willing to work MOUNTAIN time zone business hours permanently.** **Job Description** ... organizational skills + Ability to adhere to strict time constraints ** Preferred Qualifications** + Experience in Clinical Quality, Public Health, Healthcare, Waiver… more
- Molina Healthcare (Meridian, ID)
- …to determine if providers have sanctions/exclusions. * Reviews and processes daily alerts for Medicare Opt-Out reports to determine if any provider has opted out of ... Medicare . * Reviews and processes daily NPDB Continuous Query...systems. * Experience with professional written and verbal communication. ** Preferred Experience:** Experience in the health care industry To… more
- Ochsner Health (Pensacola, FL)
- …company's discretion. **Education** Required - High School Diploma or equivalent. Preferred - Bachelor's degree in marketing, business administration or related ... OR additional combination of formal education, training, and applicable experience with Medicare Advantage. **Work Experience** Required - 3 years of experience in… more