• Pre-Registration Rep Sr, Financial Securing

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …primarily work remote(Day, M- F). *Purpose of this position:*The pre-registration specialist confirms all patient demographic information is current and complete, ... and sets up appropriate Guarantor * Contacts the patient to complete Medicare Secondary Payer Questionnaire for Medicare beneficiaries * Thoroughly documents… more
    Minnesota Visiting Nurse Agency (10/11/25)
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  • Prior Authorization Technician - Remote

    Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
    …Remote Position Type Full Time Job Category Pharmaceutical Description PRIOR AUTHORIZATION SPECIALIST (REMOTE) WHO WE ARE Polaris Pharmacy Services is an industry ... Authorization Technicians to join the Polaris team. OVERVIEW The Prior Authorization Specialist is responsible for managing and identifying a portfolio of rejected… more
    Polaris Pharmacy Services, LLC (10/11/25)
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  • Bilingual Call Center Rep (Relationship…

    Healthfirst (NY)
    …eligibility, exclusion, and exemption codes. + Searches in Marx (CMS) for Medicare eligibility, enrollments, and special elections. + Achieves daily, weekly, and ... all field and tele video conference appointments for HF CompleteCare Specialist and Intake Nurses in Salesforce. + Schedules Entitlement Advocates appointments… more
    Healthfirst (10/04/25)
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  • Analyst, Coding Data Quality Auditor

    CVS Health (Topeka, KS)
    Specialist -Physician) and CRC (Certified Risk Adjustment Coder) required ** Preferred Qualifications** + CPMA (Certified Professional Medical Auditor), CDEO ... CDQA) to ensure the ICD-10 codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are… more
    CVS Health (10/02/25)
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  • Referral Supervisor

    ChenMed (Philadelphia, PA)
    …Manager and provides feedback to Center Managers when needed. + Ensures Preferred Provider List is used accurately and effectively. Collaborates with referral ... management to ensure specialist network is adequate for the geography and escalates...+ Understanding of cost as it r elates to Medicare part A and B + Ability to effectively… more
    ChenMed (09/17/25)
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  • Clinical Care Manager

    WellSense (Manchester, NH)
    …health insurance company serving members across Massachusetts and New Hampshire through Medicare , Individual and Family, and Medicaid plans. Founded 25 years ago as ... and follow-up to ensure appointment is made with the PCP or Specialist ; assessing for home health services, DME needs, and transportation issues; performing… more
    WellSense (08/22/25)
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  • Temporary Premium Billing Reconciliation…

    Martin's Point Health Care (Portland, ME)
    …Work" since 2015. Position Summary Position Summary: The Premium Billing Reconciliation Specialist role supports the accuracy and integrity of enrollment data by ... compliance with all policies, procedures, and regulations related to Medicare , DOD and the Bureau of Insurance enrollment data...maintain skillset and support for all listed Premium Billing Specialist tasks to cover and provide support as needed… more
    Martin's Point Health Care (10/01/25)
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  • Mental Health Coordinator

    UnityPoint Health (Des Moines, IA)
    …who are within two years of experiencing the onset of psychosis. The Peer Specialist on the team would help train clients experiencing early psychosis and serve as ... of agency compliance requirements for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions… more
    UnityPoint Health (09/13/25)
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  • Patient Services Representative III

    Tidelands Health (Murrells Inlet, SC)
    …and forms completed including and not limited to the following: Medicare Secondary Payer Questionnaire, Advance Beneficiary Notice (ABN waiver), HIPAA Privacy ... Notice, AOB (Assignment of Benefits), Medicare Important Messages etc. Provides information and/or handouts and answers questions on patient rights and… more
    Tidelands Health (10/14/25)
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  • Registered Nurse - RN Field Care Manager

    Humana (Detroit, MI)
    …assigned area in Wayne or Macomb county, to conduct in home visits with Medicare /Medicaid members.** The Field Care Manager Nurse 2 employs a variety of strategies, ... Qualifications** + **Registered Nurse, Nurse Practitioner, or Clinical Nurse Specialist with** **a minimum of 2** **years experience in...TB. + 75% travel is required in this position ** Preferred Qualifications** + BSN + Experience with in home… more
    Humana (10/02/25)
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