- Neighborhood Health Plan of Rhode Island (Smithfield, RI)
- …Category Professional / Experienced Description The Policy and Claims Research Specialist is responsible for supporting the Payment Integrity initiatives and ... and operational units to ensure timely resolution of open issues. The Specialist assumes ownership and accountability for the timely and accurate identification and… more
- Sprenger Wellspring Silver Maple (Lorain, OH)
- …experience in Insurance Billing field. Essential Job Functions: Responsible for Medicare , managed care, Mycare, and ancillary billing. Monthly review of outstanding ... wage based on experience, and many other benefits including: Health insurance with company paid life insurance Dental, Vision and Voluntary benefits 401k with … more
- PharmaCord (Cincinnati, OH)
- …in relevant field. Certification examples include PACS (Prior Authorization Certified Specialist ), CHES (Certified Health Education Specialist ) or CCM in ... issue resolution. Knowledge of healthcare compliance regulations, including HIPAA and Medicare /Medicaid guidelines. Bi-lingual skills are a plus. We are located in… more
- PharmaCord (Jeffersonville, IN)
- …A typical day in the life of a Medical Billing and Coding Specialist will include the following: The responsibilities include, but are not limited to ... directly within physician practices or outpatient clinics billing commercial insurances, Medicare , and Medicaid preferred Bi-lingual in English and Spanish or… more
- Insight Global (Pleasanton, CA)
- Job Description Insight Global is seeking a Medicare Billing Specialist to join their clients team. The Medicare Billing Specialist is responsible for ... the accurate preparation, submission, and reconciliation of Medicare claims for outpatient mental health services. This role ensures compliance with Medicare … more
- CVS Health (FL)
- …sales talent! We have an exciting opportunity available for highly motivated individuals as Medicare Sales Specialist . The position will be a part of a ... transforming health care. As the nation's leading health solutions company , we reach millions of Americans through our local...specialized team who will focus on educating existing Medicare members on available plan offerings to help meet… 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 for ... as necessary on all new and revised coding logic, related Medicare /Medicaid policies for review/approval through the Payment Integrity governance process.… more
- Ochsner Health (New Orleans, LA)
- …Participates in audits, projects, and regulatory consultations for the company . Performs compliance related research, conducts and documents interviews, completes ... conclusions to department and organization management. Serves as resource to company employees and management in applying and improving compliance policies,… more
- Staffing Solutions Organization (Albany, NY)
- …a reflection of our clients and the people they serve. **Senior Healthcare Program Specialist (Level 2 or 3) - Albany, NY** **Division of Eligibility & Marketplace ... Integration (DEMI)** **Bureau of Third-Party Health Insurance, Medicare Savings Program and Recoveries** **Telecommuting Option:** This position is eligible for… more
- Heritage Ministries (Conneautville, PA)
- Job Description The Facility Financial Specialist is responsible for welcoming and directing new residents and their families on the day of admission. He/she is ... face sheet, and the primary insurance coverage (other than Medicare ). Verifies the Medicare benefit and coverage...if needed. For private pay situations, will collect the company fee for this service. Will keep a standardized… more
- Cedars-Sinai (CA)
- **Job Description** The Managed Care Compliance Specialist is responsible for assisting with the implementation of the internal auditing and monitoring program ... and regulations including but not limited to AB1455 and Medicare Claims Processing Guidelines. This position is responsible for...as the need arises. + Educates CSHS employees on company policies and procedures regarding access to care, the… more
- Robert Half Accountemps (Duarte, CA)
- Description We are looking for an experienced Medical Biller/Collections Specialist to join our team in Duarte, California. The Medical Biller/Collections ... Specialist will play a vital role in managing the...claims are processed accurately and efficiently while adhering to Medicare , Medi-Cal, and other insurance guidelines. This is an… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Provides expertise to ... field. + 5 years of experience as a Sourcing Specialist or equivalent experience. **Professional Certification(s)** + Certified Purchasing...and Compensation: + Employee bonus program. + 401(k) with company match up to 4% and an additional … more
- Prime Healthcare (Ontario, CA)
- …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 one section of the report is linked to another and be able to evaluate… more
- Sumitomo Pharma (Chicago, IL)
- Sumitomo Pharma Co., Ltd. is a global pharmaceutical company based in Japan with key operations in the US (Sumitomo Pharma America, Inc.), Canada (Sumitomo Pharma ... dynamic, highly motivated individual for the position of **Multi-Specialty Portfolio Specialist /Associate Portfolio Specialist .** This position is being posted… more
- Aveanna Healthcare (Fort Worth, TX)
- …- $16.00 per hour Position Details Position: Operations Specialist (Medical Records Specialist ) Join a Company That Puts People First! Aveanna Healthcare is ... Healthcare Administrative Specialist ApplyRefer a FriendBack Job Details Requisition #:...Wellbeing Top 100 Companies of 2024 + Named Best Company for Work-Life Balance, Happiest Employees, Best Culture, and… more
- TEKsystems (Chicago, IL)
- …call quality. Heavy call volume expected from February to March. The Program Specialist is responsible for serving as the customer's primary point of contact ... reimbursement support to complex programs within Neovance. The focus of the Program Specialist is to own issues and remove obstacles that prevent patients or… more
- Sanford Health (Fargo, ND)
- …trouble shooting for pharmacists - Recording pharmacy payments in Inmar, (our reconciliation company ) - Monitoring Medicare claims to ensure payment has been ... $16.00 - $25.50 **Job Summary** The Pharmacy Business Office Specialist , supports retail pharmacy operations. The position is Monday-Friday...- Running end of month reports for Finance - Medicare and third party audits - Patient refunds and… more
- Medical Mutual of Ohio (Oklahoma City, OK)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Job Summary:** ... and Compensation: + Employee bonus program. + 401(k) with company match up to 4% and an additional ...self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans.… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …40 hours** Using discretion and independent judgment, the **Payor Relations Specialist ** (PRS), **Acute Rehab** manages the pre-certification and prior authorization ... for initiating and completing patient authorizations. The successful Payor Relations Specialist takes full responsibility from taking the initial referral until… more
