- buyer (New York, NY)
- …comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare , Child Health Plus, Exchange, Partnership in Care, ... plan contracting, delineation of risk, medical terminology and standard industry reimbursement methodologies required.Strong knowledge of CMS Medicare and NYS… more
- Independent Living Systems (Miami, FL)
- …industry. Proficient knowledge of UB04 / CMS-1500 claim adjudication process, including Medicare and Medicaid reimbursement methodologies (ie Per Diem, ... We are seeking a Senior Business Analyst to join our team at...environments. Responsibilities: Maintain data integrity of provider set-ups and reimbursement configurations, including timely updates and troubleshooting. Load and… more
- Aveanna Healthcare (Cedar Rapids, IA)
- …experience in health care (home health) preferred HHH As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related ... ongoing training and educational opportunities for Clinical staff Serves as a senior member to all staff regarding quality improvement and documentation Oversees… more
- OhioHealth (Columbus, OH)
- …entities. * This position will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid ) reimbursement is received for OhioHealth. * ... cycle, charge analysis, regulatory and financial reporting. * The Senior Reimbursement Consultant will be a subject...assigned. * Extensive knowledge of Medicare and Medicaid cost reporting and reimbursement and remaining… more
- Prime Healthcare (Ontario, CA)
- …is actively seeking new members to join our corporate team! Responsibilities The Senior Medicare - Medicaid Biller/Collector is responsible for both billing ... the specific payer guidelines, policies, procedures, and compliance regulations for Medicare - Medicaid . This includes maintaining the deficiency lists used to… more
- Prime Healthcare (Redding, CA)
- …and their family. For more information, visit www.shastaregional.com . Responsibilities The Senior Medicare - Medicaid Biller/Collector is responsible for both ... the specific payer guidelines, policies, procedures, and compliance regulations for Medicare - Medicaid . This includes maintaining the deficiency lists used to… more
- AdventHealth (Altamonte Springs, FL)
- …of relevant experience in healthcare finance, preferably in reimbursement including Medicare , Medicaid reimbursement and regulatory cost reporting Strong ... Springs, FL **The role you will contribute:** This position leads AdventHealth's Medicaid reimbursement process across the entire company focusing on… more
- Staffing Solutions Organization (Albany, NY)
- …update eligibility and claims systems. + Take the appropriate actions regarding Medicaid enrollment and premium reimbursement . + Demonstrate systems processes ... reflection of our clients and the people they serve. ** Senior Healthcare Program Specialist (Level 2 or 3) -...from a variety of sources such as Centers for Medicare and Medicaid Services (CMS), Insurance Carriers,… more
- Humana (Richmond, VA)
- …and/or other Behavioral Health contracts and agreements within the Virginia Medicaid space. The Senior Provider Contracting Professional work assignments ... and reimbursement rates to providers in building and maintaining Medicaid Behavioral Health provider networks. Analyzes the financial impact(s) of contracts and… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Medicaid Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and ... coordination of analytical processes, investigation and interpretation of Maryland Medicaid risk score methodology, risk score calculation, submissions, enrollment,… more
- Humana (Miami Lakes, FL)
- …Advantage health plans in Florida over 23 years. CarePlus strives to help people with Medicare , or both Medicare and Medicaid , achieve their best possible ... Sales Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
- Elevance Health (Independence, OH)
- … Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior ** will support our Medicare Administrative Contract (MAC) ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of...and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare… more
- CareFirst (Baltimore, MD)
- …expertise in DC Medicaid reimbursement . + Knowledge of Maryland Medicaid and Medicare reimbursement . + Excellent verbal and written communication ... maintaining fee schedules for plans that utilize the DC Medicaid reimbursement schedules and methodologies. This position...may request to extend that knowledge across other Commercial, Medicare and Medicaid plans as needed. This… more
- BayCare Health System (Clearwater, FL)
- …all levels of management. + This position is responsible for government payer reimbursement related to Medicare , Medicaid and TRICARE/CHAMPUS, specifically ... trust, dignity, respect, responsibility and clinical excellence. **Responsibilities:** + The Senior Reimbursement Analyst will work independently within their… more
- Trinity Health (Clive, IA)
- …ensure reimbursement practices adhere to federal, state and other third-party reimbursement regulations. Prepares Annual Medicare , Medicaid , Blue Cross ... the potential financial impact on the member organizations of major changes in Medicare and Medicaid policies. Assists in related advocacy efforts regarding such… more
- Marshfield Clinic (Iron Mountain, MI)
- …together to support the most exciting missions in the world!** **Job Title:** Senior Financial Analyst II - Hospital Reimbursement & Reports **Cost Center:** ... (United States of America) **Job Description:** **JOB SUMMARY** The Senior Financial Analyst II - Hospital Reimbursement ...within the Health System. This individual will assist with Medicare and Medicaid Cost Report coordination, Wage… more
- RWJBarnabas Health (Oceanport, NJ)
- …Director will serve as a key resource to department leadership for providing Medicare and Medicaid reimbursement support and implementing government payment ... policies to optimize reimbursement opportunities + Monitor Medicare and Medicaid appeal and cost report...Analyst(s) in completion of certain projects when assigned by senior management. + Assists in Reimbursement Department… more
- Prime Healthcare (Ontario, CA)
- …preparation of various government reports and support their audits. The Corporate Senior Government Reimbursement Specialist is responsible for preparing and ... understanding the complexity of a cost report. The Corporate Senior Government Reimbursement Specialist fully understands how...multi-hospital system. + Experience in preparing and completing entire Medicare and Medicaid cost reports for a… more
- Gilead Sciences, Inc. (Richmond, VA)
- …provider accounts._ + _Familiarity with pharmacy benefits, specialty payer landscape, and reimbursement pathways (commercial, Medicare , Medicaid )._ + _An ... payer policies and acquisition pathways, proactively addressing coverage and reimbursement challenges to ensure timely treatment access. Collaboration with internal… more
- University of Rochester (Brighton, NY)
- …Compliance on relevant reimbursement and billing issues and requirements (including CMS, Medicare Advantage, and New York State Medicaid ). Stays abreast of ... and expectations established for the Office of Counsel, the Senior Counsel identifies, analyzes and provides legal guidance and...the False Claims Act, Civil Monetary Penalties, and + Medicare and Medicaid billing regulations (including CMS,… more
