- Atrium Health (Charlotte, NC)
- …record using a multidisciplinary team process. Exhibits expertise associated with advanced certification in CDI. Partners with Medical and other leaders to achieve ... strategy, vision, mission, and goals. Ensures competency of Clinical Documentation Specialist staff by conducting on-going reviews and skills assessments; provides… more
- CVS Health (Richmond, VA)
- …help to support various Scorable Action Items (SAI) programs in the Medicare population, including Fraud, Waste, and Abuse (FWA), Formulary Education, Therapeutic ... for: + Performing pharmacy reviews and making evidence-based recommendations regarding Medicare members + Identifying opportunities within the health plan for… more
- Louisiana Department of State Civil Service (LA)
- …Medical Certification Specialist 2 by the absence of Centers for Medicare and Medicaid Services certification and by the level of independence exercised ... Medical Certification Specialist 1-2 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4531179) Apply Medical Certification … more
- Synergy Healthcare Solutions (Dunwoody, GA)
- …| Salary | Synergy Healthcare Services - Atlanta | Full Time **Licensing & Certification Specialist ** **Health Care Billing** **This role is onsite in our ... Medicare and Medicaid enrollment, and local business licensing/permitting. As Licensing & Certification Specialist the primary purpose of your position is to… more
- Charter Care Health Partners (Providence, RI)
- …all authorizations and pre-certs as required by the individual insurance company. The specialist will be familiar with and understand Medicare , Medicaid, other ... government payers, Commercial and HMO/PPO Payers guidelines and principals. Education: High school graduate or GED required. Associate's level degree preferred. Experience: Prior experience working in a related role in a medical office or other health care… more
- PruittHealth (Macon, GA)
- …MACON or ATHENS** **JOB PURPOSE:** The purpose of the Outreach and Enrollment Specialist role for PruittHealth Premier to serve as a licensed insurance agent to ... office space/work location is provided. The Outreach and Enrollment Specialist conducts the majority of their work within local...6. Ability to learn and carry out Centers for Medicare & Medicaid Services rules and regulations. 7. Meet… more
- Medical Mutual of Ohio (OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Under general supervision, ... remote; Ohio residents preferred._** **Responsibilities** **Provider Credentialing & Data Specialist II** + Retrieves applications and/or data from central… more
- Universal Health Services (Auburn Hills, MI)
- …as well as Admission and Discharge Important Message from Medicare , uploads Medicare Certificates and updates MIDAS certification and Medicare Screens ... Responsibilities Utilization Management - Precertification Specialist HAVENWYCK HOSPITAL (a UHS facility) Havenwyck Hospital sa Joint Commission-accredited and… more
- Medical Mutual of Ohio (Dublin, OH)
- …fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Medical Mutual' s ... best possible health and quality of life. IT Security Specialist III Performs the more complex day to day...with audits and auditors to support and maintain corporate certification initiatives. + Performs other duties as assigned. IT… more
- AdventHealth (Durand, WI)
- **Consumer Access Specialist - AdventHealth Durand** **All the benefits and perks you need for you and your family:** + Mission driven organization + Kind and caring ... patients** Verifies medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS)** **standards and communicates relevant coverage/eligibility… more
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