- WestCare Foundation (Dandridge, TN)
- …Level High School Description Position Summary: The Billing and Credentialing Specialist is responsible for overseeing insurance billing processes, managing provider ... initial credentialing and re-credentialing of clinicians with commercial insurance payers, Medicaid , Medicare, and relevant licensing boards. + Track and maintain… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Nursing Facilities Auditor** **Job Class: Human Services Program Specialist 2** **Agency: Human Services Dept** + **Job ID** : 90578 + **Location** ... reports that are submitted by stand-alone nursing facilities for compliance with Medicaid regulations + Identify and document questionable items through testing of… more
- Molina Healthcare (Iowa City, IA)
- **JOB DESCRIPTION** **Job Summary** **The Specialist , Practice Transformation implements Health Plan provider engagement strategy to achieve positive quality and ... field: Clinical Quality, Public Health or Healthcare. + 1 year of experience in Medicaid and/or Medicare managed care To all current Molina employees: If you are… more
- Trinity Health (Livonia, MI)
- …office (CVO) preferred. Certification/Licensure: Certified Professional Credentialing Specialist (CPCS) certification preferred. **REQUIRED SKILLS AND ABILITIES** ... Module (ARM) preferred. Fundamental knowledge of the Centers for Medicare and Medicaid (CMS), The Joint Commission (TJC), and National Commission for Quality… more
- Wheeler Clinic (Bristol, CT)
- …growth at all stages of life. POSITION SUMMARY The Family Support Specialist provides direct services/case management/coordination of care to an assigned caseload of ... records in accordance with documentation timelines and in compliance with Medicaid , licensing and other regulatory requirements/agencies as defined by program.… more
- Atlantic Health System (Morristown, NJ)
- …Nursing License. Preferred: 1. 2-3 years of previous OB/GYN Clinical Specialist experience preferred. 2. Certification in Advanced Practice Nurse (APRN), #LI-KA1 ... - its highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its highest five-start rating in 2020. Morristown… more
- Starfish Family Services, Inc. (Westland, MI)
- …Social Services Description POSITION SUMMARY: The Access & Customer Service Specialist is responsible for answering calls, determining eligibility, and gathering ... Maintains a working knowledge of 3rd party billing procedures for Medicare, Medicaid , MCPN and commercial insurance companies. + Monitors failed claims and… more
- BrightSpring Health Services (Englewood, CO)
- …in accordance with applicable state/federal regulations and company policies. TheRefund/Dispute Specialist works closely with other staff to identify, resolve, and ... a working knowledge of Managed Care, Commercial, Government, Medicare, and Medicaid reimbursement + Working knowledge of automated billing systems; experience with… more
- Mercy Haven Inc. (Islip Terrace, NY)
- …seeking a passionate individual for the position of Full-Time Mental Health Housing Specialist . In this impactful role, you will be instrumental in providing support ... long-range service plans + Assists in securing and maintaining entitlements: SSI/SSD, PA Medicaid , SNAP, Section 8 housing, etc. + Conducts weekly home visits and… more
- Hackensack Meridian Health (Hackensack, NJ)
- …serve as a leader of positive change. The **Integrated Case Management Specialist ** performs selected services and functions related to insurance management with ... mail in the department. Answers case management and social work phones. Medicaid appointment, all discharge functions for the Care Coordinators, including seventy… more