- Merck & Co. (North Wales, PA)
- Job DescriptionThe Central Contract Services (CCS) Senior Specialist will function as a vital member of the broader Integrated Account Management team focusing on ... teams to develop, implement, and execute contract strategies. The CCS Senior Specialist will also be responsible for driving continuous improvement of these core… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA-Claims Hiring for One Year Term **_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will not ... This role will ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for… more
- Ochsner Health (New Orleans, LA)
- …in applying and improving compliance policies, procedures and processes. Perform Medicare Coverage Analysis (MCA) for sponsored research projects. Configure studies ... Research Compliance (CHRC), Certified Professional Coder (CPC), Certified Coding Specialist (CCS) or related certification. **Knowledge Skills and Abilities (KSAs)**… more
- Molina Healthcare (Oshkosh, WI)
- **JOB DESCRIPTION** Candidate must reside in Wisconsin. Remote with field travel required in assigned territory. **Job Summary** Responsible for increasing ... membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare -Medicaid recipients within approved market areas to achieve… more
- University of Washington (Seattle, WA)
- …- Fridays + 100% Remote **POSITION HIGHLIGHTS** The **Insurance Follow-Up Specialist , Medicare ** is responsible for the optimal payment of claims from ... (FPPS)** has an outstanding opportunity for an **Insurance Follow-Up Specialist ** to join our ** Medicare ** team **.** **WORK SCHEDULE** + 100% FTE + Mondays… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA-Claims **_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will not be considered at this ... accurate, compliant, and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims… more
- Centene Corporation (New York, NY)
- …auditing, project management, or business analysis experience, preferably within the Medicare field. Previous experience coordinating cross functional teams on large ... relationships and dependencies between functional areas. This position is remote within the state of New York. Candidates must...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
- Providence (AK)
- **Description** **Charge Description Master Specialist \* Remote -Most states eligible As a member of the PSJH System Revenue Integrity Chargemaster (RICDM) team, ... the CDM Specialist shall ensure that the Chargemaster (CDM) is consistent...with inpatient and outpatient billing requirements (UB-04) and CMS Medicare reimbursement methodology. Knowledge of CPT, HCPCS and ICD10… more
- Marshfield Clinic (Marshfield, WI)
- …the most exciting missions in the world!** **Job Title:** Hospital Coding Specialist III ( Remote ) **Cost Center:** 101651098 System Support-Facility Coding ... be eligible for a sign-on bonus!**_** **JOB SUMMARY** The Hospital Coding Specialist III accurately codes inpatient conditions and procedures as documented in the… more
- Stanford Health Care (Palo Alto, CA)
- …Health Care job.** **A Brief Overview** The Single Path Coding (SPC) Specialist -Level 2 is an advanced coder position responsible for reviewing clinical ... HCPCS and the American Medical Association (AMA) CPT Assistant. The SPC Coding Specialist II serves as a subject matter expert in hospital and professional coding,… more
- Guidehouse (St. Paul, MN)
- …**Travel Required** **:** None **Clearance Required** **:** None This position is fully remote **What You Will Do** **:** + Under the direction of the Director ... services through efficient review and timely resolution of assigned Medicare and third party payer accounts that are subject...hold edits, and claim denials. **This position is 100% remote ** .Daily duties for this position include: + Perform… more
- Marshfield Clinic (Marshfield, WI)
- …most exciting missions in the world!** **Job Title:** SHP Pharmacy Benefits Specialist ( Remote in WI)) **Cost Center:** 682891381 SHP-Pharmacy **Scheduled Weekly ... **Job Description:** **JOB SUMMARY** The Security Health Plan (SHP) Pharmacy Benefit Specialist is responsible for the daily administration of the SHP pharmacy… more
- Marshfield Clinic (Marshfield, WI)
- …the most exciting missions in the world!** **Job Title:** Hospital Coding Specialist I ( Remote ) **Cost Center:** 101651098 System Support-Facility Coding ... States of America) **Job Description:** **JOB SUMMARY** The Hospital Coding Specialist I reviews clinical documentation and diagnostic results as appropriate to… more
- Molina Healthcare (Davenport, IA)
- **Job Description** **Job Summary** The Sr Specialist , Member & Community Interventions oversees and implements new and existing clinical quality member intervention ... initiatives including all lines of business ( Medicare , Marketplace, Medicaid). Executes health plan's member and community quality focused interventions and programs… more
- CareFirst (Baltimore, MD)
- …Utilizing key principles of utilization management, the Utilization Review Specialist will perform prospective, concurrent and retrospective reviews for ... clinical expertise and critical thinking skills, the Utilization Review Specialist , will analyze clinical information, contracts, mandates, medical policy, evidence… more
- Aveanna Healthcare (Chandler, AZ)
- Medical Insurance Collections Specialist ( REMOTE ) ApplyRefer a FriendBack Job Details Requisition #: 209124 Location: Chandler, AZ 85286 Category: Medical ... Accountability, Trust, Innovation, Compliance, and Fun. Position Overview The Collections Specialist is responsible for following up with invoices that have been… more
- Stanford Health Care (Palo Alto, CA)
- …Health Care job.** **A Brief Overview** Clinical Government Audit Analyst and Appeal Specialist II plays a critical role in the Revenue Cycle Denials Management ... and communication skills. The Clinical Government Audit Analyst and Appeals Specialist II will collaborate with clinical staff, coding professionals, and external… more
- Huron Consulting Group (Chicago, IL)
- …member of Huron's Research Office Team. As a Clinical Research Administrative Specialist II, you'll assist Huron's Research Office team in developing coverage ... You will also assist in review and feedback for Clinical Research Administrative Specialist I projects and will begin to support client contacts for client specific… more
- National Health Transport (Miami, FL)
- Summary: Ambulance Medical Billing Specialist is responsible for billing and collection processes for National Health Transport's ambulance trips. Ambulance Medical ... Billing Specialist answers inquiries from insurance companies, patients, and processes...+ Medical coding training and experience + Familiar with Medicare /Medicaid laws and billing + Certified Ambulance Coder helpful… more
- UPMC (Pittsburgh, PA)
- …Health Plan has an exciting opportunity for a Senior Clinical Pharmacy Specialist in the Pharmacy Services department. This is primarily a work-from-home position ... clinical management of the designated line of business (Commercial, Exchange, Medicare , Medicaid, Exchange, and/or CHIP) from a pharmacy formulary and operational… more
