| Resume alert | Resumes 11 - 20 of 787 |
Business Systems Analysis
Tamarac, FL
... Updated benefit configurations for Medicaid and Medicare members during the QNXT/administrator migration. Validated deductible and out-of-pocket maximums for accuracy. Conducted thorough analyses for capitation contracts, determining configurations ... - Apr 03
... Updated benefit configurations for Medicaid and Medicare members during the QNXT/administrator migration. Validated deductible and out-of-pocket maximums for accuracy. Conducted thorough analyses for capitation contracts, determining configurations ... - Apr 03
Data Entry Customer Service
Miami, FL
... Office Suite - Call center (inbound/outbound calling) & TeleSales - Data Entry & Appointment scheduling - Commercial insurance billing & Medicare/Medicaid - Collections Professional Experience: CVS (Temporary Remote position) Member Advocate Nov. ... - Apr 01
... Office Suite - Call center (inbound/outbound calling) & TeleSales - Data Entry & Appointment scheduling - Commercial insurance billing & Medicare/Medicaid - Collections Professional Experience: CVS (Temporary Remote position) Member Advocate Nov. ... - Apr 01
Patient Care Internal Medicine
Fort Lauderdale, FL
... Current o Responsible for direct OUTPATIENT care, same-day URGENT care, and INPATIENT care of the group’s members primarily Medicare HMO full risk patients -Physician mentor for new onboarding physicians at Optum -Peer review committee ad hoc member ... - Mar 21
... Current o Responsible for direct OUTPATIENT care, same-day URGENT care, and INPATIENT care of the group’s members primarily Medicare HMO full risk patients -Physician mentor for new onboarding physicians at Optum -Peer review committee ad hoc member ... - Mar 21
Patient Care Pharmacy Manager
Miami, FL
... Experience with HEDIS, Stars, Medicare Quality metrics, Quality improvement and Auditing. Familiar with pharmacy adjudication systems (Utilization Management) such as Prior Authorizations, Lost medications, and Vacation supplies. Conduct the ... - Mar 18
... Experience with HEDIS, Stars, Medicare Quality metrics, Quality improvement and Auditing. Familiar with pharmacy adjudication systems (Utilization Management) such as Prior Authorizations, Lost medications, and Vacation supplies. Conduct the ... - Mar 18
Customer Service Medical Coder
Hialeah, FL
... Certified Professional Medical Auditor (CPMA) – ACTIVE LICENSE, coded Pediatrics and Medicare and Medicaid Adults 1998 – 1999 National School of Technology Miami, Florida Coder / Billing Specialist Degree – ACTIVE LICENSE, coded Pediatric and Adult. ... - Mar 12
... Certified Professional Medical Auditor (CPMA) – ACTIVE LICENSE, coded Pediatrics and Medicare and Medicaid Adults 1998 – 1999 National School of Technology Miami, Florida Coder / Billing Specialist Degree – ACTIVE LICENSE, coded Pediatric and Adult. ... - Mar 12
Administrative Assistant Office Manager
Plantation, FL
... referrals, and databases ● Performing other work-related duties like project planning and general administration ● Complete Medicare Secondary Payer Questionnaire as applicable contact patient via phone to confirm or obtain demographic information ● ... - Mar 09
... referrals, and databases ● Performing other work-related duties like project planning and general administration ● Complete Medicare Secondary Payer Questionnaire as applicable contact patient via phone to confirm or obtain demographic information ● ... - Mar 09
Special Projects Computer Systems
Miami, FL
... Interact with commercial and Medicare Market leaders, other departments, and the community to promote Humana programs and strategic initiatives. Participate in special projects including participation in work groups and/or task forces may include ... - Mar 04
... Interact with commercial and Medicare Market leaders, other departments, and the community to promote Humana programs and strategic initiatives. Participate in special projects including participation in work groups and/or task forces may include ... - Mar 04
Customer Service Call Center
Fort Lauderdale, FL
... Cold Calling Leads Call Members to generate referrals Obamacare Open Enrollment and Medicare Sales – 11/2014-present Health & Life Insurance Agent-215 License Qualified and enrolled clients for Obamacare Health Insurance through the Marketplace. ... - Mar 04
... Cold Calling Leads Call Members to generate referrals Obamacare Open Enrollment and Medicare Sales – 11/2014-present Health & Life Insurance Agent-215 License Qualified and enrolled clients for Obamacare Health Insurance through the Marketplace. ... - Mar 04
Mental Health Nurse Practitioner
City Center, FL, 33139
... I am responsible for dealing with high volumes of psychiatric and complex cases and experience dealing with multiple types of payers including Medicare and commercial managed care. Currently, I am in search of an opportunity where I can utilize my ... - Feb 21
... I am responsible for dealing with high volumes of psychiatric and complex cases and experience dealing with multiple types of payers including Medicare and commercial managed care. Currently, I am in search of an opportunity where I can utilize my ... - Feb 21
Medical Billing Accounts Payable
Miami, FL
... patients, Appeals HBS- Health Business Solution 04/2004-11/2009 Billing/Collection Specialist Third party hospital collection for Medicare, Medicaid, HMO, PPO, analyzed denied claims, including reviewing the EOB to determine denial type, requesting ... - Feb 12
... patients, Appeals HBS- Health Business Solution 04/2004-11/2009 Billing/Collection Specialist Third party hospital collection for Medicare, Medicaid, HMO, PPO, analyzed denied claims, including reviewing the EOB to determine denial type, requesting ... - Feb 12