- Southeast Health (Dothan, AL)
- …Using internal and external computer systems and payer portals, work traditional Medicare and Medicare Advantage/Replacement inventory to full resolution. Job ... to obtain accurate reimbursement; + Understands the use of and navigation of Medicare 's DDE system and other governmental and commercial payer websites for claim… more
- Southeast Health (Dothan, AL)
- …Summary Job Description Shift DayShift Details FTE 1 Type Regular Join one of Forbes 500 best mid-sized employers in America. Equal Employment Employer Southeast ... Health is committed to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or… more
- NHS Management, LLC (Vestavia Hills, AL)
- …experience along the way. We are in search of a qualified Finanical Specialist Assistant: To perform the successful and timely completion of assigned business and ... + Performs assigned billing functions as directed by Financial Specialist or Administrator in the completion of all routine...related tasks, including but not limited to: + Medicaid, Medicare and/or secondary billing + Assist with evaluation and… more
- Prime Therapeutics (Montgomery, AL)
- …every decision we make. **Job Posting Title** Medication Therapy Management Specialist **Job Description** The Medication Therapy Management (MTM) Service ... Specialist is responsible for receiving inbound and making outbound...meets the specialized needs of the targeted population; for Medicare , is Centers for Medicare & Medicaid… more
- Sumitomo Pharma (Montgomery, AL)
- …highly motivated individual for the position of **Multi-Specialty Portfolio Specialist .** In this field-based role, the **Multi-Specialty Portfolio Specialist ... tactical, energetic and thrive in a nimble organization. The **Multi-Specialty Portfolio Specialist ** will demonstrate a sense of urgency to prepare and successfully… more
- CVS Health (Montgomery, AL)
- …member of our Special Needs Plan (SNP) care team, the telephonic Care Manager Specialist (CMS) plays a key role in coordinating the care of our members, particularly ... or willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care. + **Community Resources:** Familiarity with community… more
- NHS Management, LLC (Northport, AL)
- …along the way. We are in search of a qualified Financial Specialist /Medical Billing collections to join our team of dedicated professionals. Perform and/or ... billing and collection experience with nursing home receivable which includes Medicaid and Medicare Part A & B, HMO's + Experience with Medicaid Applications +… more
- Humana (Montgomery, AL)
- …approvals, as well as modeling financial impact of emerging therapeutics across Medicare and Medicaid LOBs + Researches and analyzes drugs and emerging therapeutics, ... + PharmD + Health Plan experience + Knowledge of Medicare as it relates to pharmacy + Six Sigma...or similar pharmacy practice experience + Board Certified Pharmacotherapy Specialist (BCPS) + MBA, pharmacoeconomics or health outcomes training… more
- CVS Health (Montgomery, AL)
- …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 ... record documentation review, diagnosis coding, and/or auditing. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical… more
- Evolent (Montgomery, AL)
- …Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or… more
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