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The Provider Enrollment Specialist provides support and completion of provider enrollment applications for governmental and non-governmental payers for MPOWERHealth/Acquisition Billing clients.
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Minimum of one year paralegal/legal assistant experience, preferably in healthcare environment or experience in Medicare or Medicaid provider enrollment or private payer enrollment/credentialing.
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Ensures the payor contracting department possesses relevant knowledge of commercial and Medicare Advantage payor enrollment requirements and develops and maintains provider rosters issues and a mechanism for resolving enrollment issues.
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SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation’s leading not-for-profit Medicare Advantage plans, serving more than 270,000 members in California, Arizona, and Nevada.
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Meet with consumers at a host site or at their home in order to provide information about core benefits including but not limited to Low Income Home Energy Assistance Program (LIHEAP), Medicaid, Supplemental Nutrition Assistance Program (SNAP benefits), Medicare Part D Extra Help- Low Income Subsidy (LIS), Medicare Saving Program (MSP) and provide assistance with application process as needed.
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Prepare and file a variety of state and federal licensing and certification forms, including Medicare and Medicaid provider enrollment/change of ownership forms. Among other functions, the position will assist in the drafting, proofing and finalizing of health care licensing applications, Medicare and Medicaid provider applications, and various other legal documents, and will be responsible for designing and improving processes and procedures to ensure consistent performance of complex and routine tasks.
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A Medicare Sales Representative focuses on helping people who are eligible for Medicare find a plan that meets their needs and aids them with the enrollment process. What Does a Medicare Sales Representative Do.
$70,000 - $100,000 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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The DVBC manages value-based membership growth through various enrollment levers such as; aged-in member conversion, the Medicare Annual Enrollment (AEP) Period, member voluntary alignment, acquisition membership pull through, and new provider/de-novo membership ramp.
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To be considered for this position you must have at least 2 years of Health or Medicare Insurance sales experience and have worked 2 Annual/Open Enrollment Periods. 2 years of Individual health or Medicare Insurance sales.
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Under the direction of the Business Manager, the MLTC Medical Archives Intern reviews member records and supports the Enrollment Team and the Care Management Team in correctly handling, and, as appropriate labeling and uploading the files to Disease Case Management System (DCMS), the plan's clinical record system.
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Partner with COL, credentialing coordinators and other key stake holders in onboarding and enrollment providers and facilities with Medicaid, Medicare, commercial and managed care plans.
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About NYC Health + Hospitals Metro Plus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, Metro Plus Gold, Essential Plan, etc.
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Job Description Educational/Enrollment ProcessEducate and provide assistance to qualified individuals with applying for coverage through the NY State of Health Marketplace in a Qualified Health Plan (QHP) and insurance affordability programs such as Medicaid and Child Health Plus. Assist consumers/applicants with calling the NY State of Health Customer Services Department for assistance with enrolling and/or providing verification documentation.
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Provider Enrollment Specialist (PESC) certificate. Applies advanced knowledge of regulatory and accreditation standards such as The Joint Commission (TJC), National Committee for Quality Assurance (NCQA), Centers for Medicare & Medicaid Services (CMS), Health Resources and Services Administration (HRSA) to ensure continued compliance in all matters pertaining to professional staff services.
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Keywords: Market Prominence, Medicare Enrollment, Medicare Billing, Medicaid Enrollment, Medicaid Billing, Software Development, Software Configuration. Independently designs and / or configures efficient, cost effective application program solutions for the Enrollment Operations Team on the Next Generation Platform Program for the Medicare organization, including products for Medicare Advantage (MA), Medicare Advantage with Prescription Drug Coverage (MAPD) and stand-alone Prescription Drug Plans (PDP) and potentially Medicaid.
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