- HCA Healthcare (Nashville, TN)
- …**_Note: Eligibility for benefits may vary by location._** We are seeking a Medicare Specialist for our team to ensure that we continue to ... want you to apply! **Job Summary and Qualifications** The Medicare Specialist will be responsible for all...What qualifications you will need: Minimum of 2 years Medicare claim process experience **Parallon** provides full-service… more
- Select Medical (Camp Hill, PA)
- …are exhausted. + Once patient determined to be Medicare Exhaust, specialist files Medicare part A and part B claims to Medicare . + Specialist ... Opportunity Employer/including Disabled/Veterans Apply for this job (https://jobs-selectmedicalcorp.icims.com/jobs/330016/ medicare -exhaust- specialist -%28healthcare- claims %29/job?mode=apply&apply=yes&in\_iframe=1&hashed=1374627814) Share this… more
- TEKsystems (Chesapeake, VA)
- …System . Knowledge of working FISS(Florida Institutional Shared System) in order to resolve Medicare claim issues . Keep abreast of Medicare / Medicare ... Medicare Patient Account Specialist You'll enjoy... Medicare Patient Account Specialist You'll enjoy Full Time Day Shift Hours...the area A day in the role . Submit Medicare / Medicare Advantage plan claims both… more
- 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 ... of clinic or IPA and/or managed care experience, preferred + Knowledge of Medicare Advantage billing/ claims submission and other related actions, preferred +… more
- PruittHealth (Norcross, GA)
- **JOB PURPOSE:** Compilation and verification of required third party documentation for all Medicare bad debt claims on an annual cost reporting basis. ... Calculation of allowable Medicare bad debt claims based on third...2. Validate and document each paid, adjusted, and/or denied Medicare Part A coinsurance crossover claim on… 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)
- … claims management, coding rules and guidelines, and evaluating/analyzing claim outcome results for accurate industry standard coding logic and policies ... medical coding (CPT, HCPCS, Modifiers) along with the application of Medicare /Massachusetts Medicaid claims ' processing policies, coding principals and payment… more
- Commonwealth Care Alliance (Boston, MA)
- …have direct reports. **Essential Duties & Responsibilities:** + Analyze MassHealth and Medicare claim reimbursements to ensure compliance with contractual terms, ... 011250 CCA- Claims **_This position is available to remote employees...and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director… more
- PruittHealth (Norcross, GA)
- …variances, make corrections, and take appropriate corrective actions to ensure timely claim resolutions. 8. Evaluates accounts, resubmits claims , and performs ... all Insurance billing services by final/higher level auditing, correcting, and submitting claims . Ensures that billing services are timely, accurate, and allow for… more
- Molina Healthcare (Omaha, NE)
- …of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory ... be able to rotate weekends and holidays** Must have Medicare Appeals and IRE experience** **Job Summary** Responsible for...response to incoming provider reconsideration request is relating to claims payment and requests for claim adjustments… more
- Elara Caring (Broken Arrow, OK)
- …Claims Management team. + Performs claims audits for Medicare and non- Medicare claims through completion of claim audit Workflow. + Reviews and ... the Right Time, in the Right Place. **Job Description:** ** Claim Specialist ** At Elara Caring, we care...holidays, family, and pet bereavement + Pet insurance As Claims Specialist , you'll contribute to our success… more
- NJM Insurance (Trenton, NJ)
- …evaluate the claim , and outlining and recommending an action plan to manage the claim . The WC Claims Specialist will work with and communicate to all ... NJM is seeking a Workers' Compensation (WC) Claims Specialist (I/II/Sr.) . This is...guidance and collaborative engagement during the life of a claim . The WC Claims Department takes pride… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …claims edits, "front end "edits, as well as claims edits from secondary claims . In the event a claim edit does not pass, the Follow-Up Representative must ... standards and performance measures for this position **Job Title: Claims Processing Specialist ** **Location: Pearland Administrative Office** **Department:**… more
- CenterWell (Topeka, KS)
- …+ Guide/instruct and support agency personnel encompassing all aspects of insurance and non- Medicare claims processing. + Prepare input data forms to update ... help us put health first** As an **RCM Healthcare Claims Denials Specialist /Accounts Receivable Specialist **...** , you will: + Ensure the coordination of claim activities and designated agencies, and the timely reimbursement… more
- Select Medical (Camp Hill, PA)
- **Overview** **Senior Claims Resolution Specialist ** **Starting at $18.50.00/hr but flexible for experienced candidates** Do you enjoy puzzles and research? Are ... you results-oriented? If so, our Claims Resolution Specialist position may be a... claims processing role. + Private and commercial claims collection experience (ideally provider side) + Medicare… more
- Modernizing Medicine (Sacramento, CA)
- …across the US, Chile, and Germany. ModMed (https://www.modmed.com/company/) is hiring a driven Patient Claim Specialist who will play a pivotal role in shaping a ... all inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections + Initiate outbound calls… more
- Muckleshoot Indian Tribe (Auburn, WA)
- …is responsible for assuming dual responsibility for processing routine and complex health claims as well as providing customer service for assigned accounts and for ... assuming primary responsibility for processing routine complex health claims on multiple assigned accounts. Acts as a resource for client's/community members and… more
- Community Health Systems (Birmingham, AL)
- …for insurance companies and other payers, performing in-depth research to facilitate claim resolution and maximize collections. The Billing Specialist II also ... As a Billing Specialist at Grandview Medical Group you'll join a...insurance companies, payers, and patients regarding billing inquiries and claim resolution. + Reviews and processes insurance claims… more
- 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 ... Unit (MCU) as it relates to ensuring Medicaid and Medicare compliance in Article 16 Clinics and for Independent...trends that may indicate incorrect billing. - Ensure incorrect claims are voided and reported as required to oversight… more
- Access: Supports For Living (Middletown, NY)
- …revenue management throughout the revenue cycle. This individual manages the electronic claims process, including accurate and timely claim batch creation, ... Senior Billing Specialist Location: Middletown, NY, United StatesDate Posted: Jul...billing cycle review procedures for pre-processing (scrubbing) of weekly claims processing + Analyze, billing and processing program … more