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Medicare Grievance Analyst Jobs in Arkansas

Medical Documentation Review Analyst - Medicare
By Peraton At United States
Strong PC knowledge and skills
Experience in reviewing claims for technical requirements, performing medical review, and/or developing fraud cases
Make claim payment decisions based on clinical knowledge
Bachelors degree and 5-7 years, Masters degree and 3-5 years or PhD and 0-2 years of relevant experience.
Strong communication and organization skills
Ability to present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government
Claims Compliance Analyst, Medicare
By Markel At United States
Exceptional organizational and time management skills
Bachelor’s degree or equivalent work experience
10 years of relevant work experience (12 years without bachelor’s degree)
SQL Server, Visual Basic skills preferred
Advanced to expert written and oral communication skills
Advanced analytical and problem solving skills
Medicare Pharmacy Analyst Jobs
By GeBBS Consulting At United States
Pharmacy Benefit Manager (PBM) experience
Minimum three (3) years' health related experience with health plan, pharmacy, managed care organization
Active Certified Pharmacy Technician (PTCB CPhT Certification) required
Previous Medicare Part D and/or Pharmacy Claims experience preferred.
Proficient working knowledge of MS Office Suite.
Medicare Pharmacy Analyst Jobs
By Intuitive Technology Group At United States
Knowledge of Medicare Advantage and Prescription Drug Program with a working understanding of Pharmacy Benefit Managers (PBMs).
Experience in Project Management and the ability to prepare project plans and participate or lead special projects.
Oversee Pharmacy Benefits vendors and review claims for accuracy.
Submit changes and benefit builds to the PBM and ensure quality assurance.
Experience as a project lead on one large-scale project with a successful completion (e.g., implementation, issue tracking, and resolution).
Prior quality assurance/testing experience related to claim adjudication & plan set-up preferred. Previous claims coding experience is also desirable.
Licensed Medicare Consultant Jobs
By EMERGE At United States
Extensive benefits and PTO offered
Base salary of $21-25/hr (based on experience and licensures)
1-3 years experience selling Medicare health plans
Offer relevant information on several different carriers and plans
Bonus pay of $30-50 per enrollment
Active resident-state Health Insurance License (multiple states preferred)
Program Manager, Medicare Advantage
By Premera Blue Cross At United States
(5) years of project/program management experience. (Required)
Experience leading projects within a Program/Project Management organization.
Professional project management work history.
Versed in multiple project management methods (e.g. Waterfall, Agile, Lean, Extreme, Prince2).
Experience working in different industries with a demonstrated history of natural progression with responsibilities and/or project size/complexity.
Develop and manage moderately complex project plans and budgets/financial data, and resource needs.
Intelligence Analyst - Medicare
By Peraton At United States
Bachelors degree and 8-10 years experience or Masters degree and 6-8 years experience or PhD and 3-5 years experience
Experience in relational data base design, extract, and reporting
Strong computer skills including Microsoft Excel, SQL, Outlook, and PowerPoint.
Strong proven analytical ability and basic knowledge of modelling, statistics, and sampling techniques
Strong communication and organization skills
Preferred candidates will have the following areas of concentration for work experience:
Medicare Specialist (Remote) Jobs
By Sedgwick At Washington DC-Baltimore Area, United States
Thorough knowledge of claims management
Compiles, reviews and analyzes claim files and/or management reports.
Maintains thorough understanding of service and products offered by Medicare Compliance department.
Excellent oral and written communication, including persuasive writing skills
Strong analytical and interpretive skills
Requests rated-ages; tracks files/requests/submissions through Centers for Medicare and Medicaid Services (CMS) processes; and creates documentation as required.
Medicare Specialist - Remote ($18.91 - $28.03 / Hour)
By Talentify.io At United States
Required Experience, Education And Skills
High School Diploma/GED or equivalent combination or education and experience required.
Basic math and computer skills. The ability to type 30 words per minute is a requirement.
Knowledge of medical terminology and the ability to understand and assess medical documents is strongly preferred.
Experience handling first-party medical claims is preferred.
Negotiating skills and the ability to develop effective negotiating strategies.
Medicare Product Associate Jobs
By Devoted Health At United States
The Associate will be part of a small team working in a fast-paced environment, requiring excellent time management and prioritization skills.
Qualifications (Minimum education & experience level required):
Experience with Health Plan Management System (HPMS) and CMS PBP software preferred.
Experience with benefit development, CMS bid submissions, benefit implementation, regulatory documents, or claims experience is ideal.
This position requires the candidate to have experience in healthcare, preferably with Medicare programs.
This is a highly visible role and strong interpersonal skills are a necessity.
Manager, Medicare Compliance Jobs
By Arkansas Blue Cross and Blue Shield At United States

Minimum Three (3) Years' Medicare Compliance Experience.

To learn more about Arkansas Blue Cross and Blue Shield Hiring Policies, please click here.

Pharmacy Benefit Analyst, Medicare
By Premera Blue Cross At United States
Experience in proactively applying analytical, problem solving and / or technical abilities to daily responsibilities.
In-depth knowledge of pharmacy benefit coding.
Must have Medicare Part D Benefit Experience
Strong written and verbal communication skills, and ability to experience, establish and maintain effective relationships.
Partner with customer service and contract services for language needed to develop and maintain the benefit quoting tool (BQT) database.
Bachelor’s degree or four years equivalent experience. (Required)

Are you looking for a challenging and rewarding career in healthcare? Join our team as a Medicare Grievance Analyst and help ensure that our members receive the highest quality of care!

Overview:

A Medicare Grievance Analyst is responsible for reviewing and resolving customer complaints and grievances related to Medicare services. They must ensure that all complaints are addressed in a timely manner and that all customer inquiries are answered accurately and efficiently.

Detailed Job Description:

A Medicare Grievance Analyst is responsible for reviewing and resolving customer complaints and grievances related to Medicare services. They must ensure that all complaints are addressed in a timely manner and that all customer inquiries are answered accurately and efficiently. The analyst must be able to interpret and apply Medicare regulations and policies, as well as state and federal laws. They must also be able to identify and resolve customer issues in a timely and efficient manner.

What is Medicare Grievance Analyst Job Skills Required?

• Excellent customer service skills
• Knowledge of Medicare regulations and policies
• Ability to interpret and apply state and federal laws
• Excellent communication and interpersonal skills
• Ability to work independently and as part of a team
• Ability to multitask and prioritize tasks
• Strong problem-solving and analytical skills
• Knowledge of medical terminology
• Knowledge of computer systems and software

What is Medicare Grievance Analyst Job Qualifications?

• Bachelor’s degree in healthcare administration, business administration, or related field
• At least two years of experience in a customer service or healthcare setting
• Knowledge of Medicare regulations and policies
• Ability to interpret and apply state and federal laws
• Excellent communication and interpersonal skills

What is Medicare Grievance Analyst Job Knowledge?

• Knowledge of Medicare regulations and policies
• Knowledge of medical terminology
• Knowledge of computer systems and software
• Knowledge of customer service principles and practices
• Knowledge of healthcare administration principles and practices

What is Medicare Grievance Analyst Job Experience?

• At least two years of experience in a customer service or healthcare setting
• Experience in a Medicare-related role
• Experience in a grievance or complaint resolution role

What is Medicare Grievance Analyst Job Responsibilities?

• Review and resolve customer complaints and grievances related to Medicare services
• Interpret and apply Medicare regulations and policies, as well as state and federal laws
• Identify and resolve customer issues in a timely and efficient manner
• Respond to customer inquiries accurately and efficiently
• Maintain accurate records of customer complaints and grievances
• Monitor customer satisfaction levels and take appropriate action to address any issues