- Ventura County (Ventura, CA)
- …is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare, and general insurance ... reimbursement requirements. IDEAL CANDIDATE The ideal candidate has specialized...Experienced in leading and training staff on Managed Care, Medicaid , Medi-Cal, Medicare, and Commercial Insurance, they ensure accuracy,… more
- Molina Healthcare (Dayton, OH)
- …Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits, ... understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape recommendations and action plans. + Translates… more
- Humana (Oklahoma City, OK)
- …management for network providers in Humana's Healthy Horizons in Oklahoma's Medicaid Plan, including provider onboarding, training, education, responding to provider ... as well as appropriate education about participation in Humana's Oklahoma Medicaid plan + Convene Joint Operating Committee meetings with providers, including… more
- Queen's Health System (Honolulu, HI)
- …* Demonstrated knowledge in third party and government payor and reimbursement regulations, including Medicare/ Medicaid program requirements preferred. B. ... EXPERIENCE: * In addition to the educational requirement, three (3) years experience in any or combination of the following: physician's practice, health clinic operations, medical insurance, physician practice services. * Prior experience demonstrating… more
- Logan Health (Conrad, MT)
- …audits of therapy documentation and billing. Ensures accuracy and consistency with CMS, Medicaid , and Medicare Part A & B reimbursement submissions as applicable ... to assigned area(s). + Assists leadership and makes recommendations in regards to operating and capital budgets for assigned area(s). + Leads the hiring process, preparation and delivery of evaluations and corrective action for assigned staff. + Supervisors… more
- PruittHealth (Atlanta, GA)
- …14. Knowledge of advanced directives. 15. Knowledge and understanding of Medicare, Medicaid , Private Pay and Third Party reimbursement . **MINIMUM EDUCATION ... REQUIRED:** Should possess, as a minimum, a high school diploma or its equivalent. Requires minimum two (2) years college education with courses in recreation, education, social work, other behavioral sciences or clinical services. **MINIMUM EXPERIENCE… more
- Cardinal Health (Salt Lake City, UT)
- …+ Strong understanding of medical billing practices, payer guidelines, and reimbursement methodologies (commercial, Medicare, Medicaid ). + Proven leadership and ... team management abilities. + Analytical mindset with the ability to interpret data and make strategic decisions. + Excellent communication and interpersonal skills. + Proficiency in billing and practice management software (eg, Athena, G4 Centricity, etc.). +… more
- Insight Global (Indianapolis, IN)
- …review of MAC adjustments. You will assist leadership by researching reimbursement scenarios, calculating impacts, and supporting settlement entries through the ... completion of Models 3-4 times annually. Additionally, you will handle Medicaid DSH Eligibility and HSL surveys, contributing to compliance and reimbursement … more
- National Health Care Associates (Ridgefield, CT)
- …healthcare or long-term care industry + Strong understanding of billing and reimbursement processes, including Medicare, Medicaid , and third-party payers + ... Proficiency in accounting software and Microsoft Office Suite, particularly Excel + Excellent communication skills, both verbal and written, with the ability to interact effectively with diverse stakeholders + Proven leadership abilities with experience… more
- PeaceHealth (Bellingham, WA)
- …through accurate EMR creation. + Verify billing, insurance authorizations, and Medicaid pass-throughs to ensure timely reimbursement . + Order durable ... medical equipment and manage health information systems. + Support interdisciplinary teams (nursing, social work, chaplains, volunteers, holistic therapies) with EMR and office needs. + Provide general office management support including supplies, work orders,… more