- UTMB Health (Galveston, TX)
- Director of Finance Government Reimbursement ( Medicare , Medicaid ) - Government Reimbursement **Galveston, Texas, United States** Executive - Business ... in accounting, business, or related field. and ten (10) years Medicare and Medicaid reimbursement experience, with at least six years of reimbursement experience… more
- UTMB Health (Galveston, TX)
- Reimbursement Analyst ( Medicare / Medicaid ), Partial Remote/Local - Government Reimbursement **Galveston, Texas, United States** Business, Managerial & Finance ... Business, or related field. and a minimum of three years of Medicare and Medicaid Cost Report or related experience. An equivalent combination of education and… more
- Commonwealth Care Alliance (Boston, MA)
- …This role will ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible ... research, as necessary on all new and revised coding logic, related Medicare / Medicaid policies for review/approval through the Payment Integrity governance… more
- Prime Healthcare (Redding, CA)
- …Responsibilities The Senior Medicare - Medicaid Biller/Collector ... the specific payer guidelines, policies, procedures, and compliance regulations for Medicare - Medicaid . This includes maintaining the deficiency lists used to… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Senior Medicare - Medicaid Biller/Collector ... the specific payer guidelines, policies, procedures, and compliance regulations for Medicare - Medicaid . This includes maintaining the deficiency lists used to… more
- Humana (Frankfort, KY)
- …strategy. Humana's Law Department is seeking a Counsel who will support its Medicare Advantage and Medicaid lines of business by: Providing legal advice ... contracting on behalf of a health plan or provider/vendor organization + Medicare and/or Medicaid provider contracting experience + Healthcare regulatory and/or… more
- Elevance Health (Norfolk, VA)
- **Business Information Consultant - Vendor Medicare / Medicaid Encounter Data** **Location:** Norfolk, VA; Atlanta, GA; Tampa, FL; Indianapolis, IN; Cincinnati, OH ... (preferred). This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the… more
- Guidehouse (San Antonio, TX)
- …TX office._** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare / Medicaid + Insurance Follow-up + Customer Service + Billing + UB-04 & ... CMS 1500 + Complete all business-related requests and correspondence from patients and insurance companies. + Responsible for working on 40-70 Accounts Per Day + Complete all assigned projects in a timely manner. + Assist client and patients in all requested… more
- ERP International (Laurel, MD)
- …+ **Knowledge and Skills:** + Strong knowledge of CMS enterprise functions (eg, Medicare , Medicaid , CCIIO, CHIP programs). + Expertise in regulatory analysis, ... business process modeling, and systems impact assessments. + Familiarity with interpreting data from the Federal Register and mapping it to operational or technical frameworks. + **Preferred but not required:** + Certifications such as CBAP (Certified Business… more
- Mount Sinai Health System (New York, NY)
- **Job Description** Supervisor IV-Patient Financial Services ( Medicare and Medicaid Claims Follow-Up) Corporate- Full-Time Days Responsible for the supervision ... and coordination of administrative and general office activities, consistent with departmental objectives, administrative policies and practices. Provides direct supervision for administrative and office support staff such as secretarial/administrative… more
- Commonwealth Care Alliance (Boston, MA)
- …disputes. The Claims Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare , and commercial payment methodologies and supports audit, ... accurate, compliant, and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims… more
- Molina Healthcare (Hattiesburg, MS)
- …and administration of contracts with State and/or Federal governments for Medicaid , Medicare , Marketplace, and other government-sponsored programs to provide ... State Health Department mandated laws and rulings. * Comprehensive knowledge of Medicaid , Medicare , and Marketplace policies and programs. + Compliance… more
- Aston Carter (Honolulu, HI)
- …of enrollment information and demographic changes (including coordination of benefit, Medicare Secondary Payer and Medicare Late Enrollment Penalty information), ... for all lines of business (including all post-application activities for Medicare , QUEST newborn follow-up and disability disenrollment tracking), TPL follow-up for… more
- Molina Healthcare (Worth, IL)
- …is responsible for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare - Medicaid recipients within ... Diploma/GED/AA Degree **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** + 2+ years Medicare , Medicaid , managed care or other health/insurance related sales… more
- Humana (Annapolis, MD)
- …**Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other ... Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. +… more
- Select Medical (Camp Hill, PA)
- …take ownership of the account to bill and collect from all insurances involved; Medicare , Medicaid , Commercial, etc. Their goal is to accurately collect revenue ... all authorizations are obtained as necessary and sends claims to secondary (commercial/ Medicaid ) payers along with Medicare remittance advise(s) for payment. +… more
- Humana (Denver, CO)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence… more
- Humana (St. Augustine, 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 ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- TEKsystems (San Antonio, TX)
- …accounts receivable, Emr, Epic, claims follow up, claims denials, claims appeals, medicare , medicaid , EOB, rebill claims Top Skills Details healthcare,revenue ... provider portals to collect on outstanding claims. - highly prefer medicare or medicaid collections experience * High school diploma or equivalent (GED) *… more
- Humana (Jackson, MS)
- …in hematology and oncology** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical ... Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. +… more
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