- Commonwealth Care Alliance (Boston, MA)
- …This role will ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible ... research, as necessary on all new and revised coding logic, related Medicare / Medicaid policies for review/approval through the Payment Integrity governance… more
- Prime Healthcare (Ontario, CA)
- …seeking new members to join our corporate team! Responsibilities The Senior Medicare - Medicaid Biller/Collector is responsible for both billing and collections, ... the specific payer guidelines, policies, procedures, and compliance regulations for Medicare - Medicaid . This includes maintaining the deficiency lists used to… more
- Prime Healthcare (Redding, CA)
- …family. For more information, visit www.shastaregional.com . Responsibilities The Senior Medicare - Medicaid Biller/Collector is responsible for both billing and ... the specific payer guidelines, policies, procedures, and compliance regulations for Medicare - Medicaid . This includes maintaining the deficiency lists used to… more
- Humana (Lansing, MI)
- …development for our Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Michigan Medicare - Medicaid health plan. The individual leverages a broad ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more
- Insight Global (Orlando, FL)
- …* 5+ years Backend Reimbursement experience * Cost reporting experience for Medicare / Medicaid Appeals * Experience filing state surveys + external reviews ... * 5+ years Backend Reimbursement experience * Cost reporting experience for Medicare / Medicaid Appeals * Experience filing state surveys + external reviews… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Manager Patient Accounting-Patient Financial Services ( Medicare / Medicaid ) Corporate-Full-Time Days** The Manager is responsible for ... overseeing staff, operations and resources within a department or division to ensure optimal result and high employee engagement. The Manager ensures that the department is run according to institutional policies and any applicable regulatory requirements.… more
- Providence (OR)
- …empower them.** **Providence Health Plan is calling a Clinical Program Coordinator RN, Medicare / Medicaid who will:** + Provide care coordination, case ... management and care management services to Providence Health Plans(PHP) members + Care coordination services include: disease management programs, including educating, motivating and empowering members to manage their disease + Case management services… more
- Guidehouse (Lewisville, TX)
- …from home._** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare / Medicaid + Insurance Follow-up + Customer Service + Billing + UB-04 & ... CMS 1500 + Complete all business-related requests and correspondence from patients and insurance companies. + Responsible for working on 40-70 Accounts Per Day + Complete all assigned projects in a timely manner. + Assist client and patients in all requested… more
- Molina Healthcare (New York, NY)
- …regulatory compliance and may be responsible for interfacing with the Centers for Medicare and Medicaid Services (CMS) and other regulatory agencies on matters ... of the annual marketing strategy and objectives for Molina Medicare 's portfolio of Medicare products. + Responsible...and objectives for Molina Medicare 's portfolio of Medicare products. + Responsible for supporting the development and… more
- State of Indiana (Indianapolis, IN)
- Medicaid / Medicare Coordination Manager Date Posted: Sep 5, 2025 Requisition ID: 464717 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling ... is fully engaged with this mission. Role Overview: In this role, Medicaid / Medicare Coordination Manager, you will establish priorities, targets, and deadlines… more
- Mount Sinai Health System (New York, NY)
- **Job Description** Supervisor IV-Patient Financial Services ( Medicare and Medicaid Claims Follow-Up) Corporate- Full-Time Days Responsible for the supervision ... and coordination of administrative and general office activities, consistent with departmental objectives, administrative policies and practices. Provides direct supervision for administrative and office support staff such as secretarial/administrative… more
- Commonwealth Care Alliance (Boston, MA)
- …disputes. The Claims Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare , and commercial payment methodologies and supports audit, ... accurate, compliant, and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims… more
- Centers for Medicare & Medicaid Services (Woodlawn, MD)
- …position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid ... be included in study reports, issues papers, or presentation materials related to Medicare , Medicaid or other health insurance programs; AND 3) Summarizing key… more
- Centers for Medicare & Medicaid Services (Woodlawn, MD)
- …position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid ... Innovation (CMMI), Executive Operations Staff (EOS). As a Management Analyst, GS-0343-13, you will provide technical advice and guidance to CMMI staff and managers on a variety of matters involving training, educational, and professional development programs.… more
- Centers for Medicare & Medicaid Services (Woodlawn, MD)
- …position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid ... Innovation (CMMI), State and Population Health Group (SPHG). As a Contracting Officer Representative, GS-1101-13, you will perform a variety of complex assignments related to acquisition policy, including contract representation and oversight.… more
- Humana (Indianapolis, IN)
- …and Dual Eligible Special Needs Plans (DSNP), which serve members who qualify for both Medicare and Medicaid . They will lead the state Medicaid executive ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more
- Humana (Concord, NH)
- …and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and will ... experience in an inpatient environment and/or related to care of a Medicare or Medicaid type population + Current and ongoing Board Certification in an approved… more
- Humana (Hartford, CT)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence… more
- National Health Care Associates (East Hartford, CT)
- …strong communication skills. + Excellent organization skills + General Knowledge of Medicare , Medicaid , Pending, Applied Income and Managed Care billing + ... appreciated. We invite you to join our team! **-** **Business Office /AR2/ Medicaid Specialist** **40 hour position** The position is responsible to support the… more
- Molina Healthcare (Santa Fe, NM)
- …+ Experience in Clinical Quality, Public Health, Healthcare, Ohio Waiver Services ( Medicare / Medicaid ). 5+ years of experience in Medicare and ... New Mexico residency required** **Job Description** **Job Summary** Molina's Medicaid Critical Incident Team oversees the Molina Healthcare of Ohio Medicaid … more
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