Top 20 companies that use Medicare

2. CVS Health

How CVS Health uses Medicare:

• Worked closely with leadership and managed 20 contract employees during Medicare Part D annual enrollment period.
• Directed business owners on CMS regulatory requirements for Medicare Part D and Managed Medicaid Programs (MMP) to ensure compliance.
• Contacted physician offices and pharmacies to obtain prescriptions and billed appropriate Medicare vendors.

Most common skills for CVS Health:

• Customer Service
• Patients
• CVS
• Inventory Management
• HIPAA
• Computer System

3. Prime Therapeutics

How Prime Therapeutics uses Medicare:

• Trained in Medicare, Rx Claims, Rx Express, ambassador for new hires with training and on-boarding process.
• Provide Medicare Part D members with information regarding deductibles, co-pay category, and eligibility information.
• Conduct hourly Audits on Tolling, Withdrawn and Duplicate processes per Medicare Part D compliance.

Most common skills for Prime Therapeutics:

• SAS
• Hippa
• End-To-End Testing
• Medicare
• HIPAA
• Outbound Calls

4. Hueman

5. Signature Healthcare

How Signature Healthcare uses Medicare:

• Obtain all authorizations necessary for payment from all Medicare administrated insurance companies.

Most common skills for Signature Healthcare:

• Vital Signs
• Patients
• Stoves
• Groceries
• Medicaid
• Patient Demographics

6. UnitedHealth Group

How UnitedHealth Group uses Medicare:

• Served as a valued legal resource for Medicare compliance for health plans and certain UHC employees.
• Document any member complaints and/or concerns in accordance to Medicare compliance guidelines.
• Expanded existing product offering to increase appeal in a Senior market resulting in Medicare book of business growth by 20%.

Most common skills for UnitedHealth Group:

• HIPAA
• Medicaid
• Elasticsearch
• Customer Service
• SAS
• Process Improvement

7. Sedgwick LLP

Most common skills for Sedgwick LLP:

• FMLA
• Claims Handling
• Customer Service
• Management System
• Litigation
• EDI

8. Centene

How Centene uses Medicare:

• Led strategies for introducing senior product line to Medicare Advantage Health Plans.
• Developed market growth campaign for a four-state rollout of new Medicare Advantage product.
• Lead Representative of Inbound ACD for 25 representatives supporting 6 different Medicare Plans.

Most common skills for Centene:

• Medicaid
• CMS
• NCQA
• Process Improvement
• Quality Standards
• PowerPoint

9. Guidehouse

10. Healogics

Most common skills for Healogics:

• Patients
• Ongoing Management
• UltiPro
• Data Warehouse
• Fixed Assets
• EMR

11. Marshfield Clinic Health System

Most common skills for Marshfield Clinic Health System:

• Ultrasound
• CPT
• Patients
• Content Development
• Discharge Planning
• QA

12. Oak Street Health

Most common skills for Oak Street Health:

• Patients
• Government Relations
• Office Procedures
• Python
• Primary Care
• Interview Process

13. LHC Group

How LHC Group uses Medicare:

• Directed and managed five home health agencies that provided Medicare and private home skilled and non-skilled services.

Most common skills for LHC Group:

• Home Health
• Patient Satisfaction
• CMS
• Healthcare Professionals
• Addie
• Balance Sheet Accounts

14. Highmark

How Highmark uses Medicare:

• Testified as a witness on several cases in support of Medicare regulations, manual instructions and program memorandum.
• Delegated division representative on Government Markets Product P&L Actuary Committee for CMS Medicare bid preparation.
• Provide excellent customer service including following Medicare rules and regulations.

Most common skills for Highmark:

• Strong Analytical
• Customer Service
• Medicare
• PL/SQL
• Process Improvement
• Test Cases

15. New York State Dept Of State

Most common skills for New York State Dept Of State:

• Equipment Maintenance
• Cost Estimates
• Public Safety
• Safety Guidelines
• Motor Vehicle
• Web Content

16. Hawaii Pacific Health

Most common skills for Hawaii Pacific Health:

• Crisis Management
• HIPAA
• Radiology
• Clinical Documentation
• Patients
• Account Balances

17. Tenet Healthcare

How Tenet Healthcare uses Medicare:

• Advance Directives, Conditions of Services, Consent for treatment, important Message from Medicare, EMTALA).
• Performed medical and financial chart audits for compliance of Medicare regulations.
• Managed billing/collection of Medicare, Medicaid, HMO and Self Pay.

Most common skills for Tenet Healthcare:

• Patients
• Medicaid
• Hospital Policies
• Customer Service
• Business Development
• Credit Balances

18. Kaiser Permanente

How Kaiser Permanente uses Medicare:

• Reviewed instances that were potentially reimbursable, including Medicare and other third party payers, by applying correct coding principles.
• Work with Director of Revenue Cycle to ensure adherence to Medicare billing guidelines.
• Oversee the Medicare Recovery Audit Contractors (RAC) audits.

Most common skills for Kaiser Permanente:

• Patients
• Customer Service
• Patient Care
• HIPAA
• Process Improvement
• HR

19. Cigna

How Cigna uses Medicare:

• Subject Matter Expert on Medicare D Product for Pharmacy Services.Implemented and maintained Medicare D Program in Argus for Pharmacy Operations.
• Identified Medicare overpayments to providers, perform claim system transactions, send letters, and record recoveries in appropriate database.
• Achieved Centers for Medicare and Medicaid Services, CMS, established performance goals by meeting or exceeding CMS Standards and Metrics.

Most common skills for Cigna:

• Customer Service
• SQL Server
• XML
• Process Improvement
• Healthcare
• Unix

20. Blue Cross & Blue Shield

How Blue Cross & Blue Shield uses Medicare:

• Coordinated the development of the Medicaid HMO network, the Medicare Advantage PPO network and the Blue Advantage HMO network.
• Answered incoming calls from medicare beneficiaries concerning benefits, eligibility status, payments and denials.
• Hired as a Medicare Reimbursement Analyst to audit cost reports submitted by various providers i.e.

Most common skills for Blue Cross & Blue Shield:

• Customer Service
• Medicare
• HIPAA
• CPT
• Medicaid
• Insurance Claims