- Sentara Health (Norfolk, VA)
- …and grievances. Education: HS - High School Grad or Equivalent REQUIRED Certification /Licensure: Must have Certified Professional Coder (CPC) and Certified Coding ... Specialist (CCS) from the American Health Information Management Association...Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees. Our quality provider network features… more
- Robert Half Accountemps (Fort Wayne, IN)
- Description We are looking for a detail-oriented and organized Medicare Billing Specialist to join our team in Fort Wayne, Indiana. This role involves managing ... Medicare , Medicaid, and commercial insurance claims with precision and...diploma or equivalent is required; an associate degree or certification in billing is preferred. * At least two… 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 ... organized, detail-oriented individual with: Required: + A Certified Professional Coder (CPC) certification or Certified Coding Specialist (CCS) certification … more
- 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 for ... necessary on all new and revised coding logic, related Medicare /Medicaid policies for review/approval through the Payment Integrity governance...to have the one or all of the required certification OR willing to get certified within 1 year… more
- UCLA Health (Los Angeles, CA)
- Description As the Medicare Advantage Risk Adjustment Performance Improvement Specialist , you will be responsible for: + Serving as a Subject Matter Expert (SME) ... in Los Angeles County Preferred: + Project Management (PMP) Certification , a plus + Three or more years of...of health plan experience, highly desired + Knowledge of Medicare Advantage, STARS/HEDIS program, and NCQA technical specifications +… more
- SUNY Upstate Medical University (Syracuse, NY)
- …Syracuse Inc. (UUMAS) is seeking a Registered Nurse (RN), or Certified Nurse Specialist (CNS), to coordinate and conduct Medicare Annual Wellness Visits (AWVs) ... Primary Care clinic Medical Directors and Nurse Leadership. Duties/Responsibilities: Identify Medicare patients overdue for their Medicare Annual Wellness Visit… more
- Hartford HealthCare (Farmington, CT)
- …Up/Denials Supervisor, in the day-to-day operations of the AR Follow Up & Denials Specialist Level 1, Level 2 and Level 3. Daily Operations consist of monitoring ... or professional medical billing and/or accounts receivables setting. **Licensure, Certification , Registration** . Preferred: American Academy of Professional Coders… more
- Louisiana Department of State Civil Service (LA)
- Medical Certification Specialist 1 - 2 (Field Office 2) Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/5060163) Apply Medical ... Certification Specialist 1 - 2 (Field Office...to determine compliance with state and federal regulations, including Medicare and Medicaid standards. + Review facility records, policies,… more
- Charter Care Health Partners (Providence, RI)
- …all authorizations and pre-certs as required by the individual insurance company. The specialist will be familiar with and understand Medicare , Medicaid, other ... government payers, Commercial and HMO/PPO Payers guidelines and principals. Education: High school graduate or GED required. Associate's level degree preferred. Experience: Prior experience working in a related role in a medical office or other health care… more
- Penn Medicine (Lancaster, PA)
- … Specialist license is required, issued by the PA Board of Nursing License + Certification as a Clinical Nurse Specialist from a National Certifying Body + ... in the area of specialty + Current enrollment in an accredited Clinical Nurse Specialist degree program qualifying them for certification and licensure in the… more
- University of Southern California (Alhambra, CA)
- As the center of clinical charge capture, the Revenue Integrity (RI) Specialist provides leadership to the daily CDM maintenance workflow between the various ... the standard policy for maintaining the CDM. The RI Specialist is responsible for the timely and accurate synchronization...provided. This includes ensuring all annual updates required by Medicare and other third-party payers are up to date.… more
- New York State Civil Service (NY)
- …Yes Agency People With Developmental Disabilities, Office for Title Medical Specialist 2 Occupational Category Health Care, Human/Social Services Salary Grade 38 ... Code 00000 Duties Description Primary Duties and ResponsibilitiesAs a Medical Specialist , you would actively participate in diagnosing and treating patients within… more
- University of Colorado (Aurora, CO)
- …as Medicaid or Medicare , or other resources available to patients. + Possess certification as a Colorado Peer and Family Specialist (CPFS), or another Peer ... the training already. + The employee must obtain the Colorado Peer and Family Specialist (CPFS) certification within 6 months of hire date ( certification … more
- New York State Civil Service (Brooklyn, NY)
- NY HELP Yes Agency Mental Health, Office of Title Medical Specialist 2 (NY HELPS), Kingsboro Psychiatric Center - Outpatient, P26127 Occupational Category Health ... is recruiting a physician to serve as a Medical Specialist 2. Candidates from outside or within State Service...to practice medicine in New York State and have certification by Member Board of the American Board of… more
- New York State Civil Service (Binghamton, NY)
- …Yes Agency People With Developmental Disabilities, Office for Title Medical Specialist 1 Occupational Category Health Care, Human/Social Services Salary Grade 35 ... Code 13905 Duties Description Primary Duties and Responsibilities:As a Medical Specialist , you would actively participate in diagnosing and treating patients within… more
- City and County of San Francisco (San Francisco, CA)
- …required documentation for credentialing + Possess a valid third-party billable provider certification (such as Medicare , Medi-Cal, and/or private insurance) OR ... health and substance use treatment services. Duties Include + Experienced Specialist Representative/Consultant of the specialty program or service including, but not… more
- Logan Health (Kalispell, MT)
- …about helping people navigate the world of healthcare insurance? As a Financial Clearance Specialist at Logan Health, you'll play a key role in ensuring our patients ... insurance companies and employers; ensure demographic data is correct. + Cross-reference Medicare accounts and coordinate benefit statuses as needed. + Determine and… more
- New York State Civil Service (Wassaic, NY)
- …Yes Agency People With Developmental Disabilities, Office for Title Training Specialist 1 Occupational Category Education, Teaching Salary Grade 18 Bargaining Unit ... State NY Zip Code 12592 Duties Description The Training Specialist 1 (MH) presents training programs to improve on-the-job...training courses in the agency's training program. * Attain certification as a certified instructor in the agency's 3… more
- Hartford HealthCare (Farmington, CT)
- …common practices across the system. *_Position Summary:_* The Audit & Education Specialist develops and implements an effective and comprehensive audit & education ... standards and healthcare revenue cycle industry practices. The audit and education specialist will support documentation practices that comply with CMS on evaluation… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …or related field. + 5 years of experience as a Sourcing Specialist or equivalent experience. **Professional Certification (s)** + Certified Purchasing Manager ... self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans....stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Provides expertise to the… more
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