- Houston Methodist (Houston, TX)
- …position also performs the medical necessity check, to ensure compliance with Medicare guidelines. The Patient Access Associate position employs effective ... At Houston Methodist, the Patient Access Associate position is responsible for obtaining and entering...Specialty Physician Group, Houston, TX At Houston Methodist, the Senior Medical Assistant Certified ( Sr . MA) position… more
- Sedgwick (Baton Rouge, LA)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr . Medicare Associate **Job Description** + Set up new Medicare ... records/billing industry experience preferred. Two (2) years of experience as Medicare Associate required. Internal candidates - Minimum 3.25 on most recent… more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Sr . Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of ... BSS, claims operations, and other business teams involved in the administration of Medicare business at Humana. The Senior Business Intelligence Engineer will… more
- Houston Methodist (Nassau Bay, TX)
- **Work Schedule: Saturday & Sunday 2:30pm-1am** At Houston Methodist, the Senior Patient Access Associate position is responsible for obtaining and entering ... cashier, etc.) and/or EHR work queues specific to patient access. The Senior Patient Access Associate employs effective communication skills, promoting excellent… more
- Zurich NA (Parsippany, NJ)
- Sr . Claims Specialist, Workers Compensation (Maine) 128029 Zurich is looking for an accomplished Workers Compensation Sr . Claims Specialist for or our Northeast ... New Jersey, New York, Pennsylvania, Rhode Island, or Vermont. The Senior Workers Compensation Claims Specialist will handle multi-party commercial line Workman's… more
- Fairview Health Services (Minneapolis, MN)
- …at the national and local level and provides updates to operational leaders and senior management of any Medicare or third-party payor changes that may adversely ... Care Organizations as well as mandatory government requirements for enrollment with Medicare and Medicaid (for all 50 states) to ensure uninterrupted patient access… more
- OhioHealth (Columbus, OH)
- …Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position ... will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid) reimbursement is received for OhioHealth. * This position is primarily… more
- Humana (Indianapolis, IN)
- …us put health first** Humana Healthy Horizons (HHH) in Indiana is seeking a Senior Vendor Management Professional to serve as the liaison between our members and our ... being available for the position to work remotely. The Senior Vendor Management Professional's work will involve moderately complex...one or more of the following + Medicaid + Medicare + Certification with Six Sigma and/or the Project… more
- Humana (Annapolis, MD)
- …a part of our caring community and help us put health first** The Senior Data Architect works in all data environments which includes data design, database ... architecture, metadata and repository creation. The Senior Data Architect work assignments involve moderately complex to complex issues where the analysis of… more
- Humana (Frankfort, KY)
- …help us put health first** Humana is seeking a strategic and technically adept Senior Product Owner to lead the definition and evolution of AI capabilities within ... digital and healthcare transformation goals. This is a high-impact role for a senior level product owner who thrives at the intersection of strategy, technology, and… more
- Waystar (Louisville, KY)
- **ABOUT THIS POSITION** We are seeking a highly skilled and proactive Senior Specialist, Cloud Engineer to lead and evolve our cloud infrastructure strategy. This ... network security. + **Certifications (Preferred):** + AWS Certified Solutions Architect - Associate + Microsoft Certified: Azure Administrator Associate + Google… more
- CVS Health (Denver, CO)
- …holidays Responsible for managing to resolution Fast Track Appeal scenarios for Medicare products, which contain multiple issues and may require coordination of ... GPS **Preferred Qualifications** 2-3 years' experience that includes both Medicare platforms, products, and benefits; patient management; compliance and regulatory… more
- Abbott (Livermore, CA)
- …contract negotiation, payor contract implementation, payor contract monitoring, Medicare /Medicaid enrollment, state licensing, and Joint Commission accreditation + ... Revenue Cycle Management, Commercial Contracting, and Finance **Required Qualifications** + An associate degree with a minimum of 7 years of relevant experience is… more
- Humana (Santa Fe, NM)
- …(collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Health Care Service Corporation (Chicago, IL)
- …Statistics or Economics. Other Bachelor (or higher) Degrees may be considered. + Associate of the Society of Actuaries (ASA) and Membership in the American Academy ... Visual Basic or other programming skills. + Data visualization tools experience + Medicare experience is a plus \#LI-LK1 \#LI-Hybrid \#INJLF **Are you being referred… more
- Health Care Service Corporation (Chicago, IL)
- …Statistics or Economics. Other Bachelor (or higher) Degrees may be considered. + Associate of the Society of Actuaries (ASA) and Membership in the American Academy ... Basic or other programming skills. + Data visualization tools experience + Medicare experience is a plus \#LI-LK1 \#LI-Hybrid \#INJLF **EEO Statement:** We are… more
- Commonwealth Care Alliance (Worcester, MA)
- …have):** + High School Diploma/GED **Desired Education (nice to have):** + Associate 's or Bachelor's degree **Desired Licensing (nice to have):** + clinical ... 5+ years' experience working in health care + Experience with a Medicare Advantage population preferred. + Experience with Substance Use Disorders **Required… more
- Queen's Health System (Honolulu, HI)
- …AND LICENSURE: * High School diploma or equivalent education. * Associate 's or Bachelor's degree in business, finance, accounting, healthcare or related ... facility. * Experience to demonstrate the following: o Knowledge of Medicare , Medicaid and third party requirements. o Prior supervisory/leadership experience and/or… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Medicare Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and ... not directly reporting to the Division. + Ability to work with and support Senior Management and to disseminate and summarize information into a format that can… more
- Commonwealth Care Alliance (Boston, MA)
- …Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr . Analyst plays a critical role in ensuring accurate, compliant, and timely ... reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director...issues - including underpayments, overpayments, and disputes. The Claims Sr . Analyst serves as a subject matter expert on… more
