• Novir (Milwaukee, WI)
    …Experience with insurance systems and payer platforms (eg, Medicare , Medicaid , commercial insurers). Knowledge of vaccination reimbursement policies and ... of experience working with medical billing software Experience working with HIPAA, Medicare and Medicaid regulations High school diploma or equivalent; associate… more
    Upward (07/20/25)
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  • Mount Sinai Hospital (New York, NY)
    …implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves ... and identify contract violations. *Ensure that processes related to claims submission, payment, and reimbursement are in...processes related to claims submission, payment, and reimbursement are in compliance with both internal policies and… more
    Upward (07/14/25)
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  • Gemma Law Associates (Providence, RI)
    claims . Your responsibilities will include identifying, monitoring, and resolving claims related to Medicare , Medicaid , health insurance, MedPay, ... *Open and manage subrogation claims with health insurance, MedPay, PIP carriers, Medicare , and Medicaid *Track lien and subrogation activity in the case… more
    Upward (06/27/25)
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  • Regal Medical Group, Inc. (Northridge, CA)
    …Oversee compliance with all health plan, state, and federal regulatory requirements (eg, DMHC, Medicaid , CMS Medicare Part C & D, NCQA where applicable) to prior ... the prior authorization nurse case managers and support staff (coordinators), professional claims review nurses and UM compliance staff to promote quality, cost… more
    Upward (07/16/25)
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  • Apple Rehab (Mystic, CT)
    …years experience in long-term care billing and collections; working knowledge of State Medicaid and Medicare law and third party insurance. Patience, tact and ... EHR and Billing systems, RFMS or other Resident Trust systems, and electronic claims management systems. Attention to detail, good follow through skills and ability… more
    Upward (07/16/25)
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  • Janie (Salt Lake City, UT)
    …*Prepare, review, and submit medical claims to insurance companies, government payers ( Medicare / Medicaid ), and patients *Follow up on unpaid claims and ... our revenue cycle management team, you will be responsible for processing claims , managing accounts receivable, resolving billing issues, and ensuring timely … more
    Upward (07/25/25)
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  • Community First Medical Center (Chicago, IL)
    …submission and adjudication on all claims submitted to third party carriers, Medicaid , Medicare . Respond to all inquiries according to PFS policy and ... compliance with all state and federal billing regulations. 5. Complete the follow-up of claims when an error is identified and account follow-up goals. 6. Submit the… more
    Upward (07/25/25)
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  • Oswego Health (Oswego, NY)
    …in a customer service and/or medical office setting with knowledge of Medicare , Medicaid and other contract payers preferred. Familiarity or experience ... of payer requirements, including No Fault and Workers Compensation Claims . Initiate service authorizations for services requested from practitioners. Provide… more
    Upward (07/11/25)
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  • Livingston County, NY (Geneseo, NY)
    …and local agencies; Oversees the third party billing to health insurance providers, Medicare , and Medicaid ; Devises procedures to ensure maximum third party ... of expenses, revenues, vouchers/bills, and reimbursements; Reviews grant expenditures and claims ; Approves and oversees the payroll functions related to the… more
    Upward (07/03/25)
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  • Trinity Health (Silver Spring, MD)
    …English and Spanish. Knowledge of basic medical terminology. Thorough understanding of Medicaid , Medicare and other programs that can assist the uninsured ... - Medical, Dental & Vision, PTO, Free Parking, Metro Access, Tuition Reimbursement , 403(b) Quality of Life: Flexible work schedules Advancement: Career growth… more
    Upward (06/29/25)
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  • ShopRite (Ledgewood, NJ)
    …, including but not limited to third party insurance, private insurance companies, Medicare , or Medicaid . Work cooperatively with HABA Department Associates and ... medical, dental and vision plans, paid sick and vacation time, paid holidays, life insurance, 401(k) Savings Plan with Company Match, and tuition reimbursement . more
    Upward (07/16/25)
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  • Medicare / Medicaid Claims

    Commonwealth Care Alliance (Boston, MA)
    Claims Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare , and commercial payment methodologies and supports audit, compliance, ... + Certified Professional Coder (CPC) - AAPC + Certified Claims Professional (CCP) + Other AHIMA or Medicaid...to have):** + Prior experience working with MassHealth and Medicare Advantage reimbursement rules is strongly preferred.… more
    Commonwealth Care Alliance (05/31/25)
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  • Medicare / Medicaid Claims

    Commonwealth Care Alliance (Boston, MA)
    …and medical coding (CPT, HCPCS, Modifiers) along with the application of Medicare /Massachusetts Medicaid claims ' processing policies, coding principals and ... Coding Sr. Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement ...new CPT and HCPCS codes for coding logic, related Medicare / Medicaid policies to make recommend reimbursement more
    Commonwealth Care Alliance (05/28/25)
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  • Accounting Clerk- Patient Financial Services…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Accounting Clerk- Patient Financial Services ( Medicare & Medicaid Claims Follow-Up)-Corporate 150 East 42nd Street - Full-Time Days** ... Medicaid application, financial assistance and/or determine the method of hospital reimbursement . Utilize and input into Medicaid Tracking System (MEMS) when… more
    Mount Sinai Health System (07/10/25)
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  • Patient Account Representative - Medicare

    Guidehouse (San Antonio, TX)
    …from home._** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare / Medicaid + Insurance Follow-up + Customer Service + Billing + UB-04 & ... Flexible Spending Accounts + Short-Term & Long-Term Disability + Tuition Reimbursement , Personal Development & Learning Opportunities + Skills Development &… more
    Guidehouse (06/19/25)
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  • Sr Medicare Medicaid Biller…

    Prime Healthcare (Redding, CA)
    …family. For more information, visit www.shastaregional.com . Responsibilities The Senior Medicare - Medicaid Biller/Collector is responsible for both billing and ... the specific payer guidelines, policies, procedures, and compliance regulations for Medicare - Medicaid . This includes maintaining the deficiency lists used to… more
    Prime Healthcare (07/25/25)
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  • Senior Medicare Medicaid Biller…

    Prime Healthcare (Ontario, CA)
    …seeking new members to join our corporate team! Responsibilities The Senior Medicare - Medicaid Biller/Collector is responsible for both billing and collections, ... the specific payer guidelines, policies, procedures, and compliance regulations for Medicare - Medicaid . This includes maintaining the deficiency lists used to… more
    Prime Healthcare (05/28/25)
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  • Sr Medicaid Reimbursement Regulatory…

    Zelis (Plano, TX)
    …the personal interests that shape who you are. Position Overview The Sr. Medicaid Reimbursement Regulatory Analyst will collaborate with the Zelis Regulatory ... a related field + Five+ years of experience in Medicaid billing, reimbursement , claim payment or cost...or cost reporting. + Experience with Medicare / Medicare Advantage or commercial billing and reimbursement more
    Zelis (07/12/25)
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  • Senior Healthcare Program Specialist…

    Staffing Solutions Organization (Albany, NY)
    …eligibility and claims systems. + Take the appropriate actions regarding Medicaid enrollment and premium reimbursement . + Demonstrate systems processes for ... may be received from a variety of sources such as Centers for Medicare and Medicaid Services (CMS), Insurance Carriers, and others. + Ability to problem solve… more
    Staffing Solutions Organization (07/23/25)
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  • Medicare Long Term Services & Support Care…

    AmeriHealth Caritas (Southfield, MI)
    …psychosocial needs. This role ensures that care is delivered by Centers for Medicare & Medicaid Services (CMS), state, and organizational guidelines, within the ... individuals with chronic conditions or disabilities. + Strong understanding of Medicare - Medicaid Plan Long-Term Services and Supports (MMP LTSS) programs.… more
    AmeriHealth Caritas (07/23/25)
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