- Commonwealth Care Alliance (Boston, MA)
- …that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for timely review and ... as necessary on all new and revised coding logic, related Medicare/ Medicaid policies for review/approval through the Payment Integrity governance process.… more
- Staffing Solutions Organization (Albany, NY)
- …is a reflection of our clients and the people they serve. **Healthcare Data Specialist (Level 1 or 2) - Albany, NY** **Division of Eligibility & Marketplace ... **50% Onsite 50% Remote** **Duties:** + Review reports related to Medicaid eligibility. + Utilize electronic databases to verify information. + Communicate… more
- Commonwealth Care Alliance (Boston, MA)
- …The Claims Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare, and commercial payment methodologies and supports audit, compliance, and ... - AAPC + Certified Claims Professional (CCP) + Other AHIMA or Medicaid billing-related certifications **Required Experience (must have):** + 3+ years in healthcare… more
- Centene Corporation (Jefferson City, MO)
- …include intaking and triaging suspected issues of non-compliance, entry of compliance issues into GRC tool and assignment/coordination of issues to corrections team ... members; collaborating with compliance and business stakeholders to gather information, develop corrective action plans, identify and escalate barriers to progress and gather evidence of remediation; update GRC tool to support corrections reporting. +… more
- University of Rochester (Canandaigua, NY)
- …equity considerations._ **Responsibilities:** GENERAL PURPOSE In addition to the duties of Medicaid Enrollment and Outreach Specialist (MEOS I), MEOS II supports ... Type: Full time Scheduled Weekly Hours: 40 Department: 500169 Medicaid Enrollment Work Shift: UR - Day (United States...MEOS IIs possess advanced knowledge of all aspects of Medicaid , are proficient in research, interpretation and application of… more
- Genesis Healthcare (NM)
- …savvy to our team in this remote position as a Revenue Cycle Specialist where you will manage and maintain your assigned nursing centers' Clinical Eligibility ... Medicaid Authorization tracking log to obtain valid authorizations for...and CBO supervisor to address denial issues related to Medicaid authorization. *Provide support to the nursing enters when… more
- System One (Raleigh, NC)
- …Rep Seize your opportunity to make a personal impact as a Customer Service Specialist supporting the North Carolina Medicaid . As a Customer Service Specialist ... Job Title: Customer Service Rep - Medicaid Location: Raleigh, North Carolina Type: Contract To...tomorrow is smarter. Our work depends on Customer Service Specialist II joining our team to provide customer assistance… more
- State of Montana (Helena, MT)
- …This position is with the Health Resources Division. This position is a Medicaid Claims Specialist and provides technical support primarily in the areas ... utilization and expenditures. Researches and adjudicates paid, denied, or suspended Medicaid claims independently or in coordination with program staff. Determines… more
- Sea Mar Community Health Centers (Seattle, WA)
- …identified by contracted entities such as Accountable Communities of Health and Medicaid / Medicare organizations. + The TOC Integration Specialist must maintain ... a mandatory COVID-19 and flu vaccine organization Transition of Care Integration Specialist - Posting #27558 Hourly Rate: $27.32 Position Summary: Sea Mar Community… more
- State of Indiana (Evansville, IN)
- …for Medicare & Medicaid Services certification as a Psychiatric Medicare/ Medicaid Hospital. Role Overview: Psychiatric Service Specialist II provide clinical ... Psychiatric Services Specialist Date Posted: Jul 19, 2025 Requisition ID: 461669 Location: Evansville, IN, US, 47714 Work for Indiana Begin a fulfilling career with… more