- Guidehouse (San Antonio, TX)
- …three days from home. Essential Job Functions Account Review Appeals & Denials Medicare / Medicaid Insurance Follow-up Customer Service Billing UB-04 & CMS 1500 ... Care Flexible Spending Accounts Short-Term & Long-Term Disability Tuition Reimbursement , Personal Development & Learning Opportunities Skills Development &… more
- MetroPlusHealth (New York, NY)
- …procedures (eg, claims processing P&P's, grievance procedures, state mandates, CMS/ Medicare / Medicaid guidelines, benefit plans, etc.) Research claims ... products, including, but not limited to, New York State Medicaid Managed Care, Medicare , Child Health Plus,...to live their healthiest life. Position Overview As a Claims Adjustment Specialist I, this individual will be responsible… more
- Sentara Healthcare (Virginia Beach, VA)
- …year . Sentara Health Plans division which serves more than 1.2 million commercial, Medicaid , and Medicare health plan members in Virginia and Florida Sentara is ... Work Shift First (Days) Overview: Sentara Health is hiring for a Liability Claims Manager! Status: Full-Time, permanent position (40 hours) Standard working hours: 8… more
- MIMEDX (Tampa, FL)
- …both internal and external customers Follow-up with accounts to ensure proper payment of claims , identify any reimbursement issues, and work with the account to ... serve globally. We are excited to add a Field Reimbursement Manager to our reimbursement team! The...some areas Familiarity with medical policy for insurance payers; Medicare , Medicaid , and Commercial Strong understanding of… more
- UHS (Fort Lauderdale, FL)
- …debt, while maintaining the integrity of each patient's account. Maintain knowledge Medicare / Medicaid billing requirements Understanding of Medicare codes ... knowledge of FISS system to adjust and correct RTP claims Institutionalized billing a must with knowledge of UB...outstanding patient accounts in a timely manner. Knowledge of Medicare and Medicaid billing requirements. Knowledge of… more
- Optum (San Juan, PR)
- …CMS Coverage, Federal and State Statues, Rules and Regulations Knowledge of Medicaid / Medicare Reimbursement methodologies Working knowledge of the healthcare ... . Positions in this function investigates Optum Waste and Error stopped claims by gathering information, researching state and federal guidelines, and following… more
- In Compass Health (Alpharetta, GA)
- …Assistance Program 401k with Profit Sharing match Paid Time off KEYWORDS Healthcare Medical Billing Medicare Medicaid Healthcare Management Revenue Cycle ... Professional Fee Services Understand managed care and insurance contractual arrangements Medicare , Medicaid and Managed Care Experience in Multiple States… more
- Ivy Rehab Network (White Plains, NY)
- …adult and pediatric care spectrum. Lead contract negotiations with commercial payers, Medicare Advantage plans, Medicaid managed care organizations, and other ... market trends Collaborate with revenue cycle management teams to optimize claims processing and reimbursement including resolving payer reimbursement … more
- Ultimate (Tarpon Springs, FL)
- …crucial in managing the collection of outstanding insurance balances, ensuring timely reimbursement of claims , and maintaining compliance with federal and state ... is highly preferred. Experience with verifying and interpreting medical benefits for Medicare , Medicaid , and major commercial health insurance and secondary… more
- Sherman Oaks Hospital (Sherman Oaks, CA)
- …language 6. Working experience with all payer types including: commercial, governmental, Medicare , Medicaid , HMO, etc. and the ability to cross-over into ... time off 401K retirement plan Outstanding Medical Dental Vision coverage Tuition reimbursement Many more voluntary benefit options! Benefits may vary based on… more
- Banner Health (Mesa, AZ)
- …resources and completes required documents. Maintains current working knowledge of Medicare , Medicaid and other program benefits and criteria, particularly ... including insurance and authorization verification, registration, financial counseling and claims research. This position partners with the clinical care team… more
- FROEDTERT HEALTH (Menomonee Falls, WI)
- …The Revenue & Audit Specialist is responsible for ensuring accurate billing, reimbursement , and compliance for pharmacy claims . The position will operate ... required. Experience with third party insurances including, but not limited to, Medicare and Medicaid is required. A minimum of 7 years of senior level pharmacy… more
- Sentara Healthcare (Virginia Beach, VA)
- …as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees. Our quality provider network features a ... policies and procedures May assist in problem solving with provider, claims or service issues. Required qualifications: Registered Nurse (RN) License (Compact… more
- 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 (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
- 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
- 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
- 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 (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
- Humana (Santa Fe, NM)
- …The Senior Business Intelligence Engineer will develop and maintain expertise in Medicaid reimbursement methodologies rooted in complex grouping concepts (EAPG, ... Business Intelligence Engineer will be responsible for: + Researching state-specific Medicaid reimbursement methodologies for hospitals and facilities +… more
