- State of Montana (Helena, MT)
- …for identifying and investigating potential fraud, waste, and abuse within Montana Medicaid and Healthy Montana Kids (HMK) programs. Key duties include analyzing ... retirement plans, paid vacation, sick leave, and holidays, work/life balance, and eligibility to participate in the Public Service Loan Forgiveness (PSLF) program.… more
- Aveanna Healthcare (Beaver Falls, PA)
- …individual. Must be 18 or older. Ability to work flexible hours as needed. Eligibility for State Police Criminal Record Check and Child Abuse History Clearance. FBI ... calm and professional in stressful situations Attention to detail Time Management Strong commitment to excellence Effective problem-solving and conflict resolution… more
- CVS Health (Chicago, IL)
- …each and every day. **Position Summary** + Provide actuarial support for the Medicaid Revenue Integrity projects by + Continue to improve the process for reporting ... in Excel, some programming experience **Preferred Qualifications** + Experience in Medicaid + Experience with SQL **Education** + Bachelor's degree in Actuarial… more
- Cognizant (Blaine, MN)
- …enhance our healthcare claims processing systems. With a focus on Medicare and Medicaid claims you will leverage your expertise in OnBase Application Enabler Work ... systems and enhance data exchange capabilities. - Oversee the creation and management of OnBase workflows to automate claims processing tasks. - Ensure compliance… more
- CareFirst (Baltimore, MD)
- …supports the execution of the corporate coding strategy across Medicare Advantage, Medicaid , and ACA markets. This role ensures operational compliance by supervising ... and adherence to regulatory requirements. Provide coaching, mentorship and performance management to meet productivity targets and regulatory deadlines. Assign and… more
- MyFlorida (Fort Pierce, FL)
- …System and sliding fee scale. Ensures proper CPT/ICD-10 coding for Medicare, Medicaid , and third-party payers. Responsible for ensuring compliance with state A/R ... in a clinic setting + Experience working with the Florida statewide Medicaid managed programs + Experience collecting and processing payments Preferred: +… more
- CVS Health (Charleston, WV)
- …schemes. + Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business + Researches and prepares cases for clinical and legal ... year, depending on business needs) **Preferred Qualifications** + Previous Medicaid /Medicare investigatory experience + Exercises independent judgement and uses… more
- Penn Medicine (Plainsboro, NJ)
- …X-rays. Validation includes but is not limited to verifying eligibility , obtaining benefits, ensuring pre-certification and/or authorization /referral requirements ... to have been completed. Refers patient to Medicaid Screener or Financial Counselor as needed. + Demonstrates...Media Manager. + Processes correspondence from insurance carriers, case management and other areas within one business day of… more
- UPMC (Lancaster, PA)
- …physical disabilities in the Commonwealth who are covered by Medicare and Medicaid . To provide service coordination services across the continuum of care through ... access to needed LTSS and Medical Assistance services, as well as non- Medicaid funded medical, social, housing, educational, and other services and supports.… more
- Aveanna Healthcare (Stockbridge, MA)
- …individual. Must be 18 or older. Ability to work flexible hours as needed. Eligibility for State Police Criminal Record Check and Child Abuse History Clearance. FBI ... calm and professional in stressful situations Attention to detail Time Management Strong commitment to excellence Effective problem-solving and conflict resolution… more