- Commonwealth Care Alliance (Boston, MA)
- … Claims Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare , and commercial payment methodologies and supports audit, compliance, ... + Certified Professional Coder (CPC) - AAPC + Certified Claims Professional (CCP) + Other AHIMA or Medicaid...to have):** + Prior experience working with MassHealth and Medicare Advantage reimbursement rules is strongly preferred.… more
- Commonwealth Care Alliance (Boston, MA)
- …and medical coding (CPT, HCPCS, Modifiers) along with the application of Medicare /Massachusetts Medicaid claims ' processing policies, coding principals and ... Coding Sr. Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement ...new CPT and HCPCS codes for coding logic, related Medicare / Medicaid policies to make recommend reimbursement… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Accounting Clerk- Patient Financial Services ( Medicare & Medicaid Claims Follow-Up)-Corporate 150 East 42nd Street - Full-Time Days** ... Medicaid application, financial assistance and/or determine the method of hospital reimbursement . Utilize and input into Medicaid Tracking System (MEMS) when… more
- Guidehouse (San Antonio, TX)
- …from home._** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare / Medicaid + Insurance Follow-up + Customer Service + Billing + UB-04 & ... Flexible Spending Accounts + Short-Term & Long-Term Disability + Tuition Reimbursement , Personal Development & Learning Opportunities + Skills Development &… 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
- 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
- Humana (Topeka, KS)
- …The Senior Business Intelligence Engineer will develop and maintain expertise in Medicaid reimbursement methodologies rooted in complex grouping concepts (EAPG, ... Business Intelligence Engineer will be responsible for: + Researching state-specific Medicaid reimbursement methodologies for hospitals and facilities +… more
- RWJBarnabas Health (Oceanport, NJ)
- …indicators associated with disease processes and pharmacology is required. + Knowledge of Medicare and Medicaid billing and coding regulations. + Must have ... Inpatient Coding Quality Officer III - ( Medicare )Req #:0000183242 Category:Coder Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services… more
- Cardinal Health (Doral, FL)
- …of insurance claim processing and denial management preferred. + Familiarity with Medicare , Medicaid , and managed care preferred. + Proficiency in billing ... responsible for the timely follow-up and resolution of insurance claims . This role ensures accurate and efficient collection of...cash flow for the organization. This position is a Medicaid insurance associate on the revenue cycle management team.… more
- Central Maine Medical Center (Lewiston, ME)
- …and medical terminology * Thorough understanding of various insurance plans, government agencies, Medicare and Medicaid . What It's Like Working At CMH: We are ... other every day. Central Maine Healthcare is seeking a Claims Processing Rep to join our Team. This is...we prioritize work/life balance, community-based wellness initiatives and tuition reimbursement or student loan repayment for ALL of our… more
- Humana (Denver, CO)
- …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 Claims Review Representative 3 makes appropriate claim decision based on strong knowledge of … more
- Commonwealth Care Alliance (Boston, MA)
- …of claim operations, health care reimbursement , public health care programs and reimbursement methodologies ( Medicaid and Medicare ) * Ability to work ... 011250 CCA- Claims Position Summary: Working under the direction of...Possesses a strong background in data analysis, health care reimbursement , financial analyses, provider contracting, and a broad range… more
- Masonicare (Wallingford, CT)
- …in geriatric nursing; Requires at least two (2) years experience with federal Medicare / Medicaid and Managed Care reimbursement systems with a thorough ... and monthly end of close meetings. + Assists with Medicare denial claims /reviews when need is identified...billing office. + Keeps abreast of changes in the Medicare , Medicaid and managed care areans and… more
- Otsuka America Pharmaceutical Inc. (Providence, RI)
- …+ Educate HCPs and their staff on matters related to access, coverage, reimbursement processes, claims submissions, and coding requirements + Analyze payer ... **Position Summary** The Field Reimbursement Manager (FRM) serves as the subject-matter expert...in rare disease + Strong knowledge of Centers for Medicare & Medicaid Services (CMS) policies and… more
- Philips (Plymouth, MN)
- …which includes Cash Application Specialists, Payer Relations, Patient Collections, and Reimbursement . + Reviewing and approving claims adjustment requests to ... As a Reimbursement Escalation Specialist you will analyze, problem solve...Your skills include: + Knowledge of insurnace payers, including Medicare , Medicaid , Blue Cross Blue Shield and… more
- J&J Family of Companies (Sarasota, FL)
- …approval processes and business acumen + Understanding of Medicare , Medicaid , and private payer initiatives affecting reimbursement of pharmaceutical and ... + Educate HCPs on product coverage, prior authorizations and appeals, reimbursement processes, claims submissions, procedures, and coding requirements of… more
- J&J Family of Companies (Titusville, NJ)
- …approval processes and business acumen . Understanding of Medicare , Medicaid , and private payer initiatives affecting reimbursement of pharmaceutical and ... include the following. Other duties may be assigned. . Educate HCPs on reimbursement processes, claims submissions, procedures, and coding requirements of payer… more
- J&J Family of Companies (Chicago, IL)
- …approval processes and business acumen . Understanding of Medicare , Medicaid , and private payer initiatives affecting reimbursement of pharmaceutical and ... include the following. Other duties may be assigned. . Educate HCPs on reimbursement processes, claims submissions, procedures, and coding requirements of payer… more
- University of Rochester (Rochester, NY)
- … claims and resolve billing issues. Must track payer/billing issues that affect reimbursement of claims and advising the management team of those trends and ... reports:- - - 2nd insurance level report - - Medicare and Medicaid credit balance report -...prepare log and related management reports when needed, price claims to establish the expected reimbursement in… more
- MyFlorida (Panama City, FL)
- …Prepares statistical reports as needed. Report may include number of third party reimbursement claims by vendor, amount filed, amount received, number and amount ... to maximizing local accounts receivables thru third party payers ( Medicaid , Medicaid Managed Care, Medicare ,...his/her control. Processes both electronic and manual third party claims for personal healthcare and dental services provided by… more