- Vaco by Highspring (Maitland, FL)
- …Technical accounting experience. Familiarity with Medicare /Medicaid billing and reimbursement preferred. Experience in home healthcare or long-term care ... payroll functions. Ensure compliance with GAAP, internal policies, and healthcare -specific financial regulations. Support audits, including preparation of schedules… more
- Sanford Health (Fargo, ND)
- …related field with strong financial focus. Minimum of seven years experience related to healthcare reimbursement with Medicare and other third party payers. ... regarding reimbursement functions. Directs the implementation and monitoring of reimbursement functions, which includes Medicare , Medicaid or other third… more
- Humana (Nashville, TN)
- …Senior Business Intelligence Engineer will develop and maintain expertise in complex Medicare reimbursement methodologies. This role is within the Integrated ... on Pricer edit resolution + Provide consultation to internal business partners on Medicare reimbursement /editing logic and Humana system logic **Use your skills… more
- OhioHealth (Columbus, OH)
- …entities. * This position will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid) reimbursement is received for OhioHealth. * This ... as special projects as assigned. * Extensive knowledge of Medicare and Medicaid cost reporting and reimbursement ...BS or BA in Accounting or Finance. Hospital and/or healthcare industry experience. Understanding of the CMS prospective payment… more
- Commonwealth Care Alliance (Boston, MA)
- …billing-related certifications **Required Experience (must have):** + 3+ years in healthcare claims processing, provider reimbursement , or payment integrity. + ... Experience (nice to have):** + Prior experience working with MassHealth and Medicare Advantage reimbursement rules is strongly preferred. **Required Knowledge,… more
- Prime Healthcare (Ontario, CA)
- Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360 ... health systems with nearly 57,000 employees and physicians. Eighteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a… more
- Prime Healthcare (Redding, CA)
- …compassion and community! Shasta Regional Medical Center, a member of Prime Healthcare , offers incredible opportunities to expand your horizons and be part of ... the nation for patient safety. Shasta Regional Medical Center delivers patient-centered healthcare with compassion, dignity and respect for every patient and their… more
- Highmark Health (Buffalo, NY)
- …programs. + Directly responsible to analyze and interpret data in government value-based reimbursement reports in the areas of Medicare STARS, Medicaid HEDIS and ... and engagement of primary care providers (PCP) enrolled in government value-based reimbursement programs and continuous improvement models. This job is a highly… more
- Signature Healthcare (Louisville, KY)
- …exercises such as trend and variance analysis + Understands federal and state healthcare reimbursement models including Medicare , Medicaid Case Mix, the ... Signature HealthCARE is a family-based healthcare company...forecasts, budgeting, labor and expense management, accounts receivable, cost reimbursement , and capital investing, together with the necessary processes… more
- Commonwealth Care Alliance (Boston, MA)
- …necessary on all new CPT and HCPCS codes for coding logic, related Medicare /Medicaid policies to make recommend reimbursement determinations. + Analyze, measure, ... Degree **Required Experience (must have):** + 7+ years of Healthcare experience, specific to Medicare and Medicaid...care reimbursement , public health care programs and reimbursement methodologies (Medicaid and Medicare ) + Medical… more
- Humana (Miami Lakes, FL)
- …us** About CarePlus Health Plans: CarePlus Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in ... of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live… more
- AmeriHealth Caritas (Detroit, MI)
- …; Your career starts now. We're looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we're passionate about helping people get care, stay ... well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions… more
- MVP Health Care (Schenectady, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a ** Medicare Field Sales Representative** to join #TeamMVP. This is the opportunity for ... multi-cultural environment. Must be sensitive to the needs of Medicare -eligible populations, including individuals with chronic conditions and disabilities. +… more
- Elevance Health (AR)
- …locations as necessary. **Preferred Skills, Capabilities and Experiences:** + Medicare network contracting/ reimbursement methodology strongly preferred. + ... Provider Network Management Director ( Medicare Network Build) JR167138 **Preferred Location** : Commuting...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- Centene Corporation (Trenton, NJ)
- …Purpose:** Responsible for the growth and performance of the assigned Medicare region to meet membership, pre-tax earnings, quality, network performance, provider ... and external stakeholders to become a thought leader in support of the Medicare product in the local market communities. + Identify the appropriate strategic… more
- Baylor Scott & White Health (Austin, TX)
- …Medicare , Medicaid, MCO, TPA business requirements preferred.Experience with healthcare encounters, enrollment and pharmacy data preferred. **BENEFITS** Our ... savings plan with dollar-for-dollar match up to 5%- Tuition Reimbursement - PTO accrual beginning Day 1Note: Benefits may vary...minimum qualification- EXPERIENCE + 2 Years of Experience in Healthcare Analytics + 2 years working with ACA and… more
- Houston Methodist (Katy, TX)
- …to ensure operational billing compliance with government/regulatory agencies and the Medicare and Medicaid programs. + Ensures optimization of timely cash ... Ensures that insurance follow-up and billing efforts result in optimal reimbursement . Gathers and analyzes financial information regarding charges, payments and… more
- AdventHealth (Altamonte Springs, FL)
- …10 years of relevant experience in healthcare finance, preferably in reimbursement including Medicare , Medicaid reimbursement and regulatory cost ... **The role you will contribute:** This position leads AdventHealth's Medicaid reimbursement process across the entire company focusing on supplemental Medicaid… more
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** As a Consulting Actuary at our healthcare organization, you will play a pivotal role in shaping the future of care delivery through data-driven ... benchmarking and identify emerging risks and opportunities in a rapidly evolving healthcare landscape. This role is ideal for a forward-thinking actuary who thrives… more
- Guidehouse (Lewisville, TX)
- …from home._** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare /Medicaid + Insurance Follow-up + Customer Service + Billing + UB-04 & CMS ... GED. + 0-2+ year's experience in office, business, operations, customer service or healthcare field. **What Would Be Nice To Have** **:** + Previous experience… more
