- Novo Nordisk Inc. (Tyler, TX)
- …of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage Requirements, Step Therapy, ... computer skills required (Windows, Word, Excel); Prior computer experience using sales data /call reporting software ideal Must be a self-starter and be able to… more
- DATAMAXIS (IL)
- … Medicaid agencies or equivalent supporting business initiatives through data analysis, writing business requirements and testing/validation of various systems. + ... Understanding of claims, recipient/eligibility, and provider/enrollment data processes. + Able to create and perform ...datasets. + Knowledge of the Centers for Medicare and Medicaid Services reporting requirements and the programs covered. +… more
- TEKsystems (Springfield, IL)
- …direction to ensure the successful implementation, maintenance, and enhancement of Medicaid data systems. Key Responsibilities: + Provide strategic direction ... subject matter expertise for the implementation and operation of a large-scale Medicaid data warehouse. + Lead and advise internal and external stakeholders on… more
- Staffing Solutions Organization (Albany, NY)
- …workforce, which is a reflection of our clients and the people they serve. **Healthcare Data Specialist (Level 1 or 2) - Albany, NY** **Division of Eligibility & ... **50% Onsite 50% Remote** **Duties:** + Review reports related to Medicaid eligibility. + Utilize electronic databases to verify information. + Communicate… more
- City of New York (New York, NY)
- …ELIGIBLE FOR CONTINUED EMPLOYMENT. The Home Care Services Program (HCSP) is a Medicaid funded program that provides long term care to medically fragile and ... Assisted Living Program, Care at Home Program and Homebound Medicaid . The Medicaid Eligibility Unit is responsible...and various external program applications, such as the Eligibility Data Image Transfer System (EDITS) Plus, the HRA One… more
- Genesis Healthcare (NM)
- …complexities of Medicaid eligibility? Then join us as a Regional Floating Medicaid Application Specialist . In an assigned geography, you will improve the ... and clinical eligibility requirements, asset limits, and state-specific long-term care Medicaid rules. *Monitor key performance indicators, analyze data , and… more
- Commonwealth Care Alliance (Boston, MA)
- …that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for timely review and ... necessary on all new and revised coding logic, related Medicare/ Medicaid policies for review/approval through the Payment Integrity governance...and report outcome results on edits implemented. + Utilize data to examine large claims data sets… more
- Community Health Systems (Antioch, TN)
- **Job Summary** The Collections Specialist I - Medicaid is responsible for performing collection follow-up on outstanding insurance balances, identifying claim ... adherence to applicable regulations to support revenue cycle operations. As a Collections Specialist I at Community Health Systems (CHS) - SSC Nashville, you'll play… more
- Commonwealth Care Alliance (Boston, MA)
- …The Claims Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare, and commercial payment methodologies and supports audit, compliance, and ... - AAPC + Certified Claims Professional (CCP) + Other AHIMA or Medicaid billing-related certifications **Required Experience (must have):** + 3+ years in healthcare… more
- Centene Corporation (Jefferson City, MO)
- …experience required. + Excellent Microsoft Office skills and experience with data analytics preferred. Certified in HealthCare Compliance (CHC) preferred. Certified ... Compliance & Ethics Professional (CCEP) preferred. Pay Range: $68,700.00 - $123,700.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off… more
- City of New York (New York, NY)
- …and services. The Office of Constituent Services is recruiting for eleven (11) Eligibility Specialist II's to function as a Medicaid Helpline Agents in the DSS ... BECOMES AVAILABLE, TO BE ELIGIBLE FOR CONTINUED EMPLOYMENT. The Medicaid Helpline provides information to New Yorkers on enrolling...from the client regarding their case. - Review pertinent data from New York State EMEDNY system in order… more
- City of New York (New York, NY)
- … program and services. The Office of Constituent Services is recruiting for an Eligibility Specialist II to function as a Medicaid Helpline Agent in the DSS ... call center. OCS is recruiting for fifteen (15) Eligibility Specialist II to function as Infoline/ Medicaid Helpline...from the client regarding their case. - Reviews pertinent data from New York State EMEDNY system in order… more
- University of Rochester (Canandaigua, NY)
- …equity considerations._ **Responsibilities:** GENERAL PURPOSE In addition to the duties of Medicaid Enrollment and Outreach Specialist (MEOS I), MEOS II supports ... Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500169 Medicaid Enrollment Work Shift: UR - Day (United States of America) Range: UR… more
- Staffing Solutions Organization (Albany, NY)
- …is a reflection of our clients and the people they serve. **Principal Healthcare Data Specialist 1 - Albany, NY** **Division of Eligibility & Marketplace ... Systems group as part of a team responsible for implementing the Medicaid policy/legislative changes to the Welfare Management System (WMS), the transition of… more
- HCA Healthcare (Largo, FL)
- …and integrity. We care like family! Jump-start your career as a Certified Oncology Data Specialist Part Time today with Parallon. **This is a fully remote/work ... from home position.** **Oncology Data Specialist Certification required.** **Benefits** Parallon, offers...cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon… more
- Conduent (Topeka, KS)
- …**Job Description:** As part of the KanCare Clearinghouse Program, the Customer Service Data Entry Specialist will provide quality customer service and is ... Kansas **Hours:** 8 - 4:30 pm CST **Training length:** + **Phase 1 Data Entry/Registration training:** approximately 4 weeks based on business need, class is remote.… more
- NHS Management, LLC (Daytona Beach, FL)
- …experience along the way. We are in search of a qualified Finanical Specialist Assistant: To perform the successful and timely completion of assigned business and ... quality of the business office. + Reviews, analyzes and interprets financial data to monitor progress toward established goals; identifies deterrents to success and… more
- Evolent (Lincoln, NE)
- …Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Specialist , Provider Data Management will be a dynamic role that will encompass ... overall support and maintenance of provider data . We value curiosity, creativity, and independence as we...understanding of US health care, Managed Care Organizations, and/or Medicaid . **To comply with HIPAA security standards (45 CFR… more
- Staffing Solutions Organization (Albany, NY)
- …workforce, which is a reflection of our clients and the people they serve. **Healthcare Data Specialist (Levels 1 & 2) - Albany, NY** **Division of Eligibility & ... used for tracking Unit's work + Create and update reports from departmental data , and + Assist in identifying potential risks to maintain program integrity. **Basic… more
- New York State Civil Service (Albany, NY)
- …confidentiality as appropriate, and track statuses through resolution;*Collect and analyze data to identify potential Medicaid compliance risk areas, and ... Agency Mental Health, Office of Title Mental Health Program Specialist 2, Central Office; Occupational Category Other Professional Careers...This position is located within the OMH Bureau of Medicaid Program & Policy and will be working with… more
