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The ideal candidate has at least 10 + years of experience in HEALTHCARE, specifically with an ACO (Accountable Care Organization), MSO Management Service Organization), Medicare Advantage Plan, or related.
$230,000 - $260,000 a yearExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Initiates Prior Authorization submissions and completes all follow ups for all insurance Payors including Medicare Advantage, Medicaid’s, HMO, PPO, and Commercial until the case has reached a determination.
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Basic knowledge of billing guidelines and resources for Medicare and Private insurances. Maintains working knowledge of billing guidelines and resources for Medicare and Private Insurances.
$17 - $18 an hourFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Experience in at least 3 of the following areas:- IBNR and reserve setting- General pricing and filing support of Individual products- General pricing and filing support of Small Group products- General pricing and filing support of Large Group products- Assist in Medicare Advantage Bid filing- Evaluation of Managed Medicaid programs- Provider Contract evaluations- Provider Profit/withhold settlement evaluations- Product Experience Monitoring- Reinsurance/Stop-loss Reporting.
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Experience with Medicare Advantage STARS or Risk Adjustment. Works to develop and deliver high impact interventions, supporting content development and practice transformation embedded capabilities to significantly improve provider performance that drive cost of care and improve HEDIS/Stars where applicable.
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Highly developed business acumen and insight, especially in regard to managed care plans, Medicare Advantage, Field Marketing Organizations and Value-Based Care industries. Proven history of superior sales results and sales management experience in health insurance, Medicare Advantage or Value-Based Care space.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Build and maintain Clinician’s workflow and HEDIS quality measure for Medicare Advantage program. REMOTE*The University of Miami Health System, "UHealth", IT Department has an exciting opportunity for an Epic Analyst – Healthy Planet.
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Join the revolutionary Flex Rates platform and uncap your earnings on the industrys best work from home Medicare sales platform, selling Medicare Advantage, Supplement, and Prescription Drug plans to inbound, in-market shoppers.
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The Billing Specialist is responsible for obtaining pre-certification and pre-authorizations for DME procedure codes by completing the authorization process with commercial payers. Compiles pre-certification information to submit prior authorization requests via outbound phone calls and/or web-based sites (familiarity with payors.
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Our primary care physicians are true hands-on caregivers transforming the health and lives of seniors on Medicare Advantage. Holistic Health Services: Acupuncture, Tai Chi, Yoga and Nutrition.
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Location: Hybrid in Doral, FL, with 1st 90 days fully Onsite. Conducts outbound and/or inbound calls to patients, doctor's offices, insurance companies as necessary or required to complete tasks. Performs regular follow-up calls with insurance companies to check status of prior authorization request.
Full-timeExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Directs, coordinates, and oversees patient care within a defined clinical practice of the University: Kendall outpatient office for the Medicare Advantage (MSO) population; provides supervision, mentoring, training and development to clinical staff.
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This organization is a Medicare Advantage Institutional Special Needs Health Plan (ISNP) for long-term nursing home residents. The plan covers all medically necessary and preventive services covered under Medicare Parts A, B, and D. They are strongly focused on improving their members' physical, mental, and social well-being through personalized clinical care and therapies.
Part-timeRemoteExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Work with the Sr. Administrative Officer, Chair and Practice Managers of the PAC Family Medicine Clinic on administrative matters like credentialing, scheduling, finances, policies and procedures, quality management and compliance regulations, electronic medical records guidelines for open encounters and inbasket and leave management for the clinic.
Full-timeExpandApply NowActive JobUpdated 12 days ago - UpvoteDownvoteShare Job
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Quickly grasp new concepts and product offerings, such as Major Medical, Medicare Advantage, Medicare Supplement, Prescription Drug Plans, and other ancillary health products. As a Medicare Sales Agent (internally titled Advocate Agent) you'll enjoy unlimited earning potential, the convenience to work from home, access to best-in-class paid training, and potentially the opportunity to move into a leadership role.
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medicare advantage jobs in Miami, FL
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