- buyer (New York, NY)
- …including, but not limited to, New York State Medicaid Managed Care, Medicare , Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, ... being proud of what you do every day.The Government Programs Policy Specialist conducts regulatory research and assists in the implementation of various government… more
- RELI GROUP INC (Baltimore, MD)
- Job Details Job Location Windsor Mill, MD Remote Type Fully Remote Position Type Full Time Education Level 4 Year Degree Description About Us: At RELI Group, our ... is seeking a detail-oriented Data Analyst / Business Activity Monitoring (BAM) Specialist to support the Information Security and Privacy Services (ISPS) under the… more
- Clever Care Health Plan (Huntington Beach, CA)
- …the healthcare space? We are one of Southern California's fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth. Who ... the supervision of the Vice President of Operations, the Credentialing Specialist supports all credentialing operations, including direct monitoring of the delegated… more
- PharmaCord (Jeffersonville, IN)
- …it to our Talent Acquisition team immediately at ###@pharmacord.com This is a hybrid/ remote eligible role. Candidates may be eligible for a hybrid schedule (50% in ... office, 50% remote ) once training is successfully completed (training program usually...relevant field. Certification examples include PACS (Prior Authorization Certified Specialist ), CHES (Certified Health Education Specialist ) or… 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
- Molina Healthcare (Bellevue, WA)
- …of Member Materials. **Knowledge/Skills/Abilities** + Conducts direct outreach to new Medicare members to provide personal assistance with their new MAPD, DSNP, ... database. + Participate in Member engagement work groups as needed to ensure Medicare member needs are being anticipated and addressed. + Participates in regular… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA-Claims Hiring for One Year Term **_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will not ... This role will ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for… more
- Ochsner Health (New Orleans, LA)
- …in applying and improving compliance policies, procedures and processes. Perform Medicare Coverage Analysis (MCA) for sponsored research projects. Configure studies ... Research Compliance (CHRC), Certified Professional Coder (CPC), Certified Coding Specialist (CCS) or related certification. **Knowledge Skills and Abilities (KSAs)**… more
- Molina Healthcare (Green Bay, WI)
- **JOB DESCRIPTION** Candidate must reside in Wisconsin. Remote with field travel required in assigned territory. **Job Summary** Responsible for increasing ... membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare -Medicaid recipients within approved market areas to achieve… 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
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA-Claims **_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will not be considered at this ... accurate, compliant, and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA-Claims **_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will not be considered at this ... Claims Operations & Quality Assurance, the Regulatory Compliance & Audits Sr. Specialist II is responsible for ensuring CCA's operational compliance with state and… more
- TEKsystems (Atlanta, GA)
- Program Specialist REMOTE Pay Rate: $21/hr Schedule: Ranges M-F 8am-8:30pm EST Anticipated Start Date: 12/1/2025 End Date: 3/31/2026 Contract length: 4 months ... Training period: 8 weeks (December 1 - February 1) Description The Program Specialist is responsible for serving as the customer's primary point of contact providing… more
- Marshfield Clinic (Marshfield, WI)
- …the most exciting missions in the world!** **Job Title:** Hospital Coding Specialist III ( Remote ) **Cost Center:** 101651098 System Support-Facility Coding ... be eligible for a sign-on bonus!**_** **JOB SUMMARY** The Hospital Coding Specialist III accurately codes inpatient conditions and procedures as documented in the… more
- Aveanna Healthcare (Chandler, AZ)
- Billing Specialist ( REMOTE ) ApplyRefer a FriendBack Job Details Requisition #: 208121 Location: Chandler, AZ 85286 Category: Medical Billing/Collections Salary: ... Accountability, Trust, Innovation, Compliance, and Fun. Position Overview The Billing Specialist reports directly to the Reimbursement Supervisor and is responsible… more
- Marshfield Clinic (Marshfield, WI)
- …the most exciting missions in the world!** **Job Title:** Reimbursement Auditing Specialist ( Remote in Wisconsin) **Cost Center:** 101651059 Coding-Audit Appeals ... residents only eligible to apply**_** **JOB SUMMARY** The Reimbursement Auditing Specialist assists personnel in various areas of Revenue Integrity/Revenue Cycle as… more
- Cognizant (Juneau, AK)
- **Provider Appeals & Grievances Specialist ** ( remote ) This is a remote position open to any qualified applicant that lives in the United States. **Summary:** ... We are seeking a dedicated Provider Appeals & Grievance Specialist with 1 to 2 years of experience to join our team. The ideal candidate will have strong technical… more
- Marshfield Clinic (Marshfield, WI)
- …to support the most exciting missions in the world!** **Job Title:** ROI Specialist ( Remote in Wisconsin) **Cost Center:** 201081277 HIM-Release of Information ... residents only eligible to apply**_** **JOB SUMMARY** The Release of Information Specialist is responsible for supporting the organization by obtaining records from… more
- National Health Transport (Miami, FL)
- Summary: Ambulance Medical Billing Specialist is responsible for billing and collection processes for National Health Transport's ambulance trips. Ambulance Medical ... Billing Specialist answers inquiries from insurance companies, patients, and processes...+ Medical coding training and experience + Familiar with Medicare /Medicaid laws and billing + Certified Ambulance Coder helpful… more
- Molina Healthcare (Yonkers, NY)
- **Job Description** **Job Summary** The Specialist , Member & Community Interventions implements new and existing clinical quality member intervention initiatives ... including all lines of business ( Medicare , Marketplace, Medicaid) Executes health plan's member and community...or Healthcare Administration + 1 year of experience in Medicare and in Medicaid managed care + Certified Professional… more
