- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance **Position Summary:** The Senior Provider Relations Specialist is responsible for building, maintaining and ... to enhance provider satisfaction and member access to care. Reporting to the Senior , Director of Delegation Partnerships., the Senior Provider Relations Account… more
- Staffing Solutions Organization (Albany, NY)
- …a diverse workforce, which is a reflection of our clients and the people they serve. ** Senior Healthcare Program Specialist (Level 2 or 3) - Albany, NY** ... Eligibility & Marketplace Integration (DEMI)** **Bureau of Third-Party Health Insurance, Medicare Savings Program and Recoveries** **Telecommuting Option:** This… more
- WesleyLife (Johnston, IA)
- …values your growth, well-being, and happiness. With over 78 years of excellence in senior living, we believe in empowering our team members to make a difference ... supportive, and rewarding work environment. **A Typical Day for a Medical Billing Specialist at our Network Support Center:** + Manage Third Party billing across all… more
- Commonwealth Care Alliance (Springfield, MA)
- …complexities that require intensive care management and care delivery. Within the CIC Program , The Senior Clinician, Behavioral Health (SBHC) serves as a leader ... and eCW a plus) + Experience with Medicaid or Medicare programming and insurance products (ie ACO, MCO, PACE...2, PHQ 9) + Demonstrates understanding of Referral to Specialist . + Ability to conduct and document a Pain… more
- Zurich NA (Parsippany, NJ)
- Sr . Claims Specialist , Workers Compensation 128029 Zurich is looking for an accomplished Workers Compensation Sr . Claims Specialist for or our Northeast ... Jersey, New York, Pennsylvania, Rhode Island, or Vermont. The Senior Workers Compensation Claims Specialist will handle...Litigation Management area.OR + Completion of Zurich Claims Training Program and 6 or more years of experience in… more
- Waystar (Louisville, KY)
- **ABOUT THIS POSITION** While our Sr . Specialist Application Engineers are involved in multiple things throughout the Technology organization, primarily they are ... Client Success department in resolving issues relating to production processes. The Sr . Specialist Application Engineer is responsible for troubleshooting and… 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 ... related field. + 5 years of experience as a Sourcing Specialist or equivalent experience. **Professional Certification(s)** + Certified Purchasing Manager… more
- University of Miami (Miami, FL)
- …of Miami/UHealth Department of SCCC has an exciting opportunity for a Full Time Sr . Sponsored Programs Specialist to work at the UHealth campus in Miami, ... Fl. CORE JOB SUMMARY The Sr . Sponsored Programs Specialist coordinates administrative and...of funding proposals. Responds to general inquiries regarding sponsored program policies and procedures. Reviews grant applications to ensure… more
- UCHealth (Fort Collins, CO)
- Description Patient Access Specialist Sr , Rehab Services Location: UCHealth Harmony Campus 2121, US:CO: Fort Collins Department: PVH Rehab Services At Harmony ... physician. Verifies insurance eligibility for governmental insurance payors (ie Medicaid, Medicare , Tricare, etc.). May complete Medicare Secondary Payor… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** We are seeking a highly skilled and proactive Senior Specialist , Site Reliability Engineering (SRE) to help drive reliability, ... passion for automation, observability, and operational excellence. As a Senior Specialist , you'll work on complex reliability...systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out… more
- Waystar (Atlanta, GA)
- …hospitals and health systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out our organizational values: ... family planning programs, including adoption assistance and fertility support + 401(K) program with company match + Pet insurance + Employee resource groups Waystar… more
- Waystar (Atlanta, GA)
- …from complex PDF documents (leveraging OCR, document layout analysis, Named Entity Recognition (NER), and Relationship Extraction (RE)). + Develop rich, nested JSON ... systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out...programs, including adoption assistance and fertility support + 401(K) program with company match + Pet insurance + Employee… more
- Commonwealth Care Alliance (Boston, MA)
- …Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr . Analyst plays a critical role in ensuring accurate, compliant, and timely ... reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director...issues - including underpayments, overpayments, and disputes. The Claims Sr . Analyst serves as a subject matter expert on… more
- Molina Healthcare (Cedar Rapids, IA)
- **Job Description** **Job Summary** The Sr Specialist , Member & Community Interventions oversees and implements new and existing clinical quality member ... and/or collaboratively with other departments. **Job Duties** + Acts as a lead specialist to provide project, program , and/or initiative related direction and… more
- City and County of San Francisco (San Francisco, CA)
- …2232's may include, but are not limited to: + Disease Prevention and Control Senior Specialist /Medical Director + Provides clinical oversight of a unit or clinic ... COVID, influenza, measles, Salmonella, HIV, STIs, Tuberculosis or emerging diseases. + Senior Specialist in Forensic Pathology + Performs medicolegal autopsies… more
- Access: Supports For Living (Middletown, NY)
- Senior Billing Specialist Location: Middletown, NY, United StatesDate Posted: Oct 17, 2025 Share: share to e-mail Apply Now Save JobSaved Description Location: ... (40hrs) Job Description: Reporting to the A/R Manager, the Senior Billing Specialist is a key position...of weekly claims processing + Analyze, billing and processing program claims for accuracy and completeness; submit claims to… more
- Prime Healthcare (Ontario, CA)
- …preparation of various government 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… more
- Marshfield Clinic (Marshfield, WI)
- …most exciting missions in the world!** **Job Title:** Pharmacy Systems Support Specialist Senior **Cost Center:** 301641560 System Ancillary Region-340b Admin ... America) **Job Description:** **JOB SUMMARY** The Pharmacy Systems Support Specialist Senior helps facilitate and support the...or be excluded from participation in any federally funded program , including Medicare and Medicaid. This is… more
- Molina Healthcare (Chicago, IL)
- …accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist , Quality Interventions / QI Compliance ... and Quality Improvement Compliance. + Acts as a lead specialist to provide project-, program -, and /...Healthcare. **Preferred Experience** + 1 year of experience in Medicare and in Medicaid. + Experience with data reporting,… more
- CenterWell (Booneville, MS)
- …a part of our caring community and help us put health first** As a ** Senior Clinical Home Health Specialist ** , you will call on physicians, hospital, skilled ... in special projects, quarterly Customer Appreciation Week events and specialty program launches. **Use your skills to make an impact** **Required Experience/Skills:… more
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