• Medicare /Medicaid Claims Editing…

    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 for ... necessary on all new and revised coding logic, related Medicare /Medicaid policies for review/approval through the Payment Integrity governance...all of the required certification OR willing to get certified within 1 year of employment - + … more
    Commonwealth Care Alliance (05/28/25)
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  • Clinical Documentation Integrity Specialist

    UCLA Health (Los Angeles, CA)
    Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and ... individual with: + A Certified Professional Coder (CPC) certification or Certified Coding Specialist (CCS) certification, required + A Certified more
    UCLA Health (05/16/25)
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  • Coding Specialist - Medicare

    BlueCross BlueShield of North Carolina (NC)
    …school diploma or GED + 3+ years of experience in related field + Certified Professional Coder **Bonus Points** + Medicare coding and auditing experience **What ... patterns and reports relevant data to the Centers for Medicare and Medicaid Services (CMS). **What You'll Do** +...coding and reports relevant data to the Centers for Medicare and Medicaid Services (CMS). + Uses all resources… more
    BlueCross BlueShield of North Carolina (07/23/25)
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  • Medicare /Medicaid Claims Reimbursement…

    Commonwealth Care Alliance (Boston, MA)
    …accurate, compliant, and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims ... Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare , and commercial payment methodologies and supports audit, compliance, and provider… more
    Commonwealth Care Alliance (05/31/25)
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  • Medicare Annual Wellness Visit Registered…

    SUNY Upstate Medical University (Syracuse, NY)
    …Inc. (UUMAS) is seeking a Registered Nurse (RN), or Certified Nurse Specialist (CNS), to coordinate and conduct Medicare Annual Wellness Visits (AWVs) across ... preferred. 3-5 years of direct experience in a Primary Care setting preferred. Certified Nurse Specialist (CNS) preferred. Work Days: Monday - Friday 8:00… more
    SUNY Upstate Medical University (05/29/25)
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  • Board Certified Behavior Analyst (BCBA),…

    State of Colorado (Grand Junction, CO)
    Board Certified Behavior Analyst (BCBA), (Clinical Behavioral Specialist II) - Grand Junction Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4889241) Apply  Board Certified Behavior Analyst (BCBA), (Clinical Behavioral Specialist II) -… more
    State of Colorado (06/30/25)
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  • Certified Coding Specialist I-…

    UPMC (Pittsburgh, PA)
    **UPMC Health Plan has an exciting opportunity for a Certified Coding Specialist I position in the Medicare HCC department. This is a full time position ... total experience. + Knowledge of Microsoft Office. **Licensure, Certifications, and Clearances:** Certified Coding Specialist (CCS) OR Certified Professional… more
    UPMC (07/30/25)
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  • Certified Peer Specialist -Youth…

    State of Georgia (Rockdale County, GA)
    Certified Peer Specialist -Youth (GLS) Rockdale/Newton Georgia - Rockdale (https://ga.referrals.selectminds.com/jobs/69841/other-jobs-matching/location-only) Hot ... rates, lower dropout rates, decreased ER visits and decreased inpatient admissions. The Certified Peer Specialist ~ Youth will work as an integral team… more
    State of Georgia (07/02/25)
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  • Certified Peer Specialist Senior

    WellSpan Health (York, PA)
    …Preferred and + Professional office work experience. Preferred **Licenses:** + Certified Peer Specialist Upon Hire Required **Driver's License Statement:** ... health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and… more
    WellSpan Health (07/23/25)
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  • Certified Peer Specialist - Lebanon…

    WellSpan Health (Lebanon, PA)
    …Preferred and + Professional office work experience. Preferred **Licenses:** + Certified Peer Specialist Upon Hire Required **Driver's License Statement:** ... health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and… more
    WellSpan Health (07/05/25)
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  • Certified Peer Specialist (CPS-MH)…

    State of Georgia (Newton, GA)
    Certified Peer Specialist (CPS-MH) - New Rock Peer Support - Covington, GA Georgia - Newton - Covington ... disabilities. View Point Health serves uninsured, underinsured, low-income Medicaid, Medicare , war veterans and some private insurance across multiple locations… more
    State of Georgia (07/02/25)
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  • Certified Peer Specialist

    WellSpan Health (York, PA)
    …Preferred and + Professional office work experience. Preferred **Licenses:** + Certified Peer Specialist Required **Driver's License Statement:** Must possess ... health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and… more
    WellSpan Health (06/20/25)
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  • Certified Coding Specialist

    Randolph Hospital (Asheboro, NC)
    …accepted. Knowledge of ICD-9-CM, CPT-4 coding guidelines. Knowledgeable of current Medicare and Medicaid rules and regulations. Experience in encoder software. ... Knowledge of abstracting and use of databases. Ability to interact professionally with all levels of personnel. Ability to work under pressure. Excellent communication skills required. Minimum of two years coding experience within an acute care setting. more
    Randolph Hospital (05/08/25)
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  • Program Operations Specialist 1 / Trainee…

    New York State Civil Service (Schenectady, NY)
    …Agency People With Developmental Disabilities, Office for Title Program Operations Specialist 1 / Trainee - Upstate Occupational Category Other Professional Careers ... the Medicaid Compliance Unit (MCU) as it relates to ensuring Medicaid and Medicare compliance in Article 16 Clinics and for Independent Practitioner Services for… more
    New York State Civil Service (07/24/25)
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  • Peer Recovery Specialist Patient Services

    University of Colorado (Aurora, CO)
    **Peer Recovery Specialist Patient Services** **Description** **University of Colorado Anschutz Medical Campus** **School of Medicine | Department of Psychiatry | ... Services (ARTS) | Adult Outpatient Program** **Job Title: Peer Recovery Specialist - Patient Services** **Position: #00828232 - Requisition: #35187** **Job… more
    University of Colorado (06/07/25)
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  • Medical Certification Specialist 1-2

    Louisiana Department of State Civil Service (LA)
    …from Medical Certification Specialist 2 by the absence of Centers for Medicare and Medicaid Services certification and by the level of independence exercised in ... Medical Certification Specialist 1-2 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4818520) Apply  Medical Certification Specialist 1-2… more
    Louisiana Department of State Civil Service (05/07/25)
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  • EAP Specialist (Hybrid)

    UPMC (Pittsburgh, PA)
    UPMC's Health Plan and WorkPartners are hiring an EAP Specialist for their LifeSolutions Clinical Services Team. This is a hybrid role that will work partially ... experience working with geriatric behavioral health and dual eligible (Medicaid and Medicare ) populations. Under the direction of LS Clinical Director and/or the… more
    UPMC (07/04/25)
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  • (Hybrid/Remote) Coding Compliance…

    Trinity Health (Livonia, MI)
    …equivalent certification required, eg, Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Registered Health Information Technologist ... Health & Human Services (DHHS) - Office of Inspector General (OIG), Centers for Medicare & Medicaid Services (CMS), Department of Justice (DOJ) as well as input… more
    Trinity Health (05/13/25)
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  • Peer Specialist

    WellSpan Health (York, PA)
    …meetings as scheduled. + Completes no less than 10 shadowing hours with a current Certified Peer Specialist . + Completes no less than 8 billable shadowing hours ... with a Lead Certified Peer Specialist . + Completes and passes...organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest… more
    WellSpan Health (07/03/25)
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  • Coding Specialist (40 hours/week on 1st…

    Penn Medicine (East Petersburg, PA)
    …Minimum Required Qualifications: + High school diploma or equivalent GED + Certification as Certified Coding Specialist for Physicians CCS-P or a Certified ... Health Information Technician , RHIA Registered Health Information Administrator , CCS Certified Coding Specialist , COC-A Certified Outpatient… more
    Penn Medicine (07/29/25)
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