• Senior Analyst, Medical Economics (Vbc) - Remote

    Molina Healthcare (KY)
    …their financial and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **Job ... + 5+ years of related experience in healthcare + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans + Analytical work… more
    Molina Healthcare (08/31/25)
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  • RN Care Manager - Remote, nationwide

    Humana (Frankfort, KY)
    …day to day flexibility in care manager's schedule. **Duties:** + Telephonically assess Medicare , Medicaid , and/or and Group Account members and create actionable ... match * Generous Paid Time Off accrual * Tuition Reimbursement * Parent Leave * Go365 perks for well-being...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
    Humana (09/06/25)
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  • Bilingual Case Manager

    Cardinal Health (Frankfort, KY)
    …insurance processes. Remain knowledgeable about long and short-range changes in the reimbursement environment including Medicare , Medicaid , Managed Care, and ... + High School diploma or equivalent preferred + Knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers policies and guidelines for coverage, preferred… more
    Cardinal Health (09/03/25)
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  • Senior Corporate Compliance Consultant- Healthcare…

    Baylor Scott & White Health (Frankfort, KY)
    …in a timely way. . Responds to inquiries and guidance requests utilizing applicable Medicare and Medicaid rules and regulations. Serves as a compliance resource ... to ensure compliance with BSWH policies and CMS and Texas Medicaid regulations, providing reports, recommendations, and corrective action follow-up. Monitors trends… more
    Baylor Scott & White Health (09/07/25)
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  • Senior Corporate Compliance Consultant- Billing…

    Baylor Scott & White Health (Frankfort, KY)
    …lessons are completed in a timely way. . Responds to inquiries utilizing applicable Medicare and Medicaid guidance. Serves as a compliance resource to BSWH ... to ensure compliance with BSWH policies and CMS and Texas Medicaid regulations, providing reports, recommendations, and corrective action follow-up. Monitors trends… more
    Baylor Scott & White Health (09/07/25)
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  • Sr QNXT and NetworX Product Specialist

    Cognizant (Frankfort, KY)
    …making for right configuration by working with Business team . Familiarity with Medicaid and Medicare programs are minimum requirements. **Salary and Other ... Fee schedules, Service groups, etc. . Understand and build solutions for Medicaid - QNXT Benefit configuration matrix. . Conduct requirements discovery sessions with… more
    Cognizant (09/06/25)
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  • Sr. Product Manager - Claims Management

    Waystar (Louisville, KY)
    …1K+ hospitals and health systems, and is connected to over 5K commercial and Medicaid / Medicare payers. We are deeply committed to living out our organizational ... of hospital & professional coding and billing workflows and the provider reimbursement process, obtained either through direct experience in a healthcare setting or… more
    Waystar (08/08/25)
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  • Claims Specialist

    BrightSpring Health Services (Louisville, KY)
    …national Medicare D plans, third party insurance companies and all state Medicaid plans to ensure maximum payer reimbursement adhering to critical deadlines ... Dental, Vision, and Life Insurance + Company-Paid Disability Insurance + Tuition Assistance & Reimbursement + Employee Discount Program + 401k Plan + Paid Time Off +… more
    BrightSpring Health Services (08/30/25)
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  • Medical CoPay Claims Processor

    AssistRx (Louisville, KY)
    …program business rules. + Strong understanding of Government benefits such as Medicare , Medicaid , and Tricare. + Documenting and reporting payment information. ... working knowledge of prescription plans and billing policies to ensure compliance and reimbursement . + Monitor profitability of orders, manage claim queues (eg, 3 &… more
    AssistRx (08/27/25)
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  • Profee Medical Coder Complex Surgical Pediatric

    Banner Health (KY)
    …compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the ... information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or… more
    Banner Health (09/06/25)
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