- 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
- 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
- St. Luke's University Health Network (Bethlehem, PA)
- …serve, regardless of a patient's ability to pay for health care. The Pre- Certification Specialist is responsible for contacting health insurance companies prior ... to verify coverage either online or by telephone. The precertification specialist is also responsible for relaying precertification information to performing… 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 (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
- Medical Mutual of Ohio (OH)
- …quarterly on-site requirement in Brooklyn, OH_** **Responsibilities** **Business Systems Specialist I** Works with management, external vendors, and Information ... more junior staff. . Performs other duties as assigned. **Business Systems Specialist II** Works with management, external vendors, and Information Systems to… more
- AdventHealth (New Smyrna Beach, FL)
- …New Smyrna Beach **The role you'll contribute:** _The_ _Social Work Specialist intervenes with patients who have complex psychosocial needs, require assistance ... are provided and documented in a timely manner for compliance: Important Medicare Letters (IML), Medicare Outpatient Observation Notice (MOON), Patient Choice,… more
- City and County of San Francisco (San Francisco, CA)
- …required documentation for credentialing + Possess a valid third-party billable provider certification (such as Medicare , Medi-Cal, and/or private insurance) OR ... Public Health continuously accepts applications for all Senior Physician Specialist positions. + ✅Start with this Required Questionnaire https://forms.office.com/g/2a7KLdZBTz… more
- Health First (Palm Bay, FL)
- …secure the required forms to meet compliance with regulatory policies. 3. Perform Medicare compliance review on all applicable Medicare accounts to determine ... coverage. 4. Identify patients who may need Medicare Advance Beneficiary Notices of Noncoverage (ABNs). 5. Issue ABN forms as needed. 6. Complete Medicare … more
- New York State Civil Service (Castorland, NY)
- …No Agency People With Developmental Disabilities, Office for Title Habilitation Specialist 1 CNYDDSO Occupational Category Health Care, Human/Social Services Salary ... Zip Code 13620 Minimum Qualifications MINIMUM QUALIFICATIONS:Currently a permanent Habilitation Specialist 1.If you are currently a New York State employee serving… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …will serve as a liaison to the Grievance and Appeals Department for Medicare Advantage appeals. The Utilization Review Specialist (LVN) is responsible for ... **Responsibilities** The Utilization Review Specialist (LVN) is responsible for conducting medical reviews,...Texas Department of Insurance (TDI) and or Centers for Medicare and Medicaid (CMS) and healthplan requirements. The Utilization… more
- New York State Civil Service (Thiells, NY)
- …the American Board of Medical Specialties (ABMS) in your specialty. OR* Medicaid and Medicare certified. OR* Current Medical Specialist 2. OR* Eligible for 70.1 ... Disabilities policies and regulations.* Maintain qualifications for Specialty and for Medicare and Medicaid certification of provider status.* Other duties… more
- CareOregon (Portland, OR)
- …care costs and increase provider/care team satisfaction. Housecall Providers has saved Medicare millions of dollars, while providing better care to our patients, ... diseases. This trend will continue as roughly 10,000 baby boomers a day enter the Medicare system. If you receive an offer of employment for this position, it is… more
- Bassett Healthcare (Little Falls, NY)
- …with the Medical Director of Respiratory Care Services, the Respiratory Specialist is responsible for assisting in the development, implementation, and ... administration of all policies and procedures. The Respiratory Care Specialist performs all roles and responsibilities of a Respiratory Therapist. The Respiratory… more
- Marshfield Clinic (Marshfield, WI)
- …in the world!** **Job Title:** SHP Pharmacy Quality Assurance - Auditing Specialist (Remote, hybrid or in office) **Cost Center:** 682891381 SHP-Pharmacy **Scheduled ... **Job Description:** **JOB SUMMARY** The SHP Pharmacy Quality Assurance/Auditing Specialist monitors, performs, and manages quality assurance processes including… more
- Catholic Health Initiatives (Lexington, KY)
- …**Job Summary / Purpose** The Patient Assistance Coordinator/Pharmacy Operations Specialist is responsible for CHI Saint Joseph Health System's Medication ... Assistance Programs. The Patient Assistance Coordinator/Pharmacy Operations Specialist applies knowledge of pharmaceuticals, insurance plans, social security… more
- Hackensack Meridian Health (Brick, NJ)
- …Required:** + Current state Registered Nurse license. + Certified Clinical Documentation Specialist (CCDS) or certification within two (2) years of eligibility. ... and serve as a leader of positive change. The **Clinical Documentation Specialist RN** facilitates improvement in the overall quality, completeness and accuracy of… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Required:** + Current state Registered Nurse license. + Certified Clinical Documentation Specialist (CCDS) or certification within two (2) years of eligibility. ... and serve as a leader of positive change. The **Clinical Documentation Specialist RN** facilitates improvement in the overall quality, completeness and accuracy of… more
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