- Apex Health Solutions (Houston, TX)
- …and direct communication to all applicable parties (internal and external). The pharmacy specialist will also work with the compliance department to perform ... Position Summary: The Pharmacy services Specialist will assist the Clinical Services staff (pharmacists...in all aspects of pharmacy operations and services including Medicare part D oversight, coverage determination and re-determination (appeal)… more
- UPMC (Pittsburgh, PA)
- …or activities relative to the information obtained from these reports. + Facilitate compliance to the Medicare 72-Hour Rule by identifying and investigating ... UPMC Corporate Revenue Cycle is hiring a DRG Specialist II to join our coding team! This...utilization, diagnostic complications and co-morbidities have been coded in compliance with coding guidelines, third-party payer and OIG regulations.… more
- Trinity Health (Ypsilanti, MI)
- **Employment Type:** Full time **Shift:** **Description:** The focus of the Accounting Specialist is to guide and support compliant clinical research billing and ... to ensure that clinical research studies are billed in compliance with the CMS National Coverage Determination Decision, all...study protocol, budget and consent form to prepare a Medicare coverage analysis. + Prepare submissions to the … more
- Bon Secours Mercy Health (Oberlin, OH)
- …clinicians are recognized for clinical and operational excellence. **_Patient Access Specialist - Mercy Allen Hospital (Oberlin, OH)_** **Shift/Schedule:** + Part ... meeting the mission and goals of Mercy Health ministry and all regulatory compliance requirements. The Spec Patient Access will work within the policies and… more
- Robert Half Accountemps (Doylestown, PA)
- Description We're looking for a detail-oriented Medical Accounts Receivable Specialist to join our team in Doylestown, Pennsylvania. In this long-term contract ... position, you will play a vital role in managing Medicare billing, insurance claims, and patient accounts to ensure...ensuring all patient accounts are handled with accuracy and compliance . * Submit electronic and paper insurance claims following… more
- Molina Healthcare (UT)
- **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
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Audit Readiness Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... achieve that purpose. Job Summary The Customer Solution Center (CSC) Audit Readiness Specialist II is responsible for the execution, oversight, and monitoring of the… more
- Johns Hopkins University (Baltimore, MD)
- We are seeking a **_Coding Specialist II_** who will be responsible for all aspects of coding, quality assurance, compliance with Federal payer documentation ... Responsibilities** + Responsible for all aspects of coding, quality assurance and compliance with Federal payer documentation guidelines. + Works closely with Office… more
- DiPasquale Moore (Kansas City, MO)
- Health Insurance Lien Specialist / Administrative Assistant Kansas City, Missouri Competitive salary commensurate with experience! REQUIREMENTS: High School Diploma ... Job Overview: We are seeking a Health Insurance Lien Specialist to join our personal injury law firm. The...related to health insurance and their liens, including Medicaid, Medicare , and ERISA. This role is crucial in ensuring… more
- Centers for Medicare & Medicaid Services (Woodlawn, MD)
- … Specialist , GS-13, you will develop, evaluate, and implement compliance , audit, and oversight requirements, policies, and operating procedures related to ... Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare... Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid Innovation, Seamless Care Models Group, Division… more