- Virtua Health (Cherry Hill, NJ)
- …experience in a medical practice or ambulatory medical setting. Knowledge of insurance (ICD-9 CPT coding, Medicare regulations, state regulations, CLIA, DOH, ... regulations) preferred. Solid knowledge of and experience in billing and health insurance guidelines and practices, including commercial, Medicare and managed… more
- RWJBarnabas Health (Oceanport, NJ)
- …will serve as a key resource to department leadership for providing Medicare and Medicaid reimbursement support and implementing government payment strategies across ... This includes planning, preparing and reviewing of the annual Medicare /Medicaid cost reports filings. In partnership with the Vice...Paid Time Off (PTO) + Medical and Prescription Drug Insurance + Dental and Vision Insurance +… more
- Fallon Health (Springfield, MA)
- …hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE- in the region. **Brief ... Summary of Purpose:** Responsible for the effective management and delivery of direct nursing care to PACE participants in any setting utilizing nursing process and adhering to standards of nursing practice. **Responsibilities** **Responsibilities** : +… more
- Fallon Health (Webster, MA)
- …hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE- in the region. **Brief ... Summary of purpose** Responsible for the effective management and delivery of direct nursing care to PACE participants in any setting utilizing nursing process and adhering to standards of nursing practice. **Responsibilities** **Primary Job Responsibilities**… more
- Insight Global (Philadelphia, PA)
- Job Description A leader in the health insurance space (Medicaid/ Medicare ) space is actively hiring for a REMOTE Sr. Business Systems Analyst to own the ... requirements of their Pharmacy Benefits Management (PBM) business platform. This is a small IT Team of 3 people that are all responsible for delivering technical projects for the PBM line of business. As the Systems Analyst you will leverage your SDLC… more
- CareFirst (Baltimore, MD)
- …in Business or Healthcare Administration. + Knowledge of healthcare or health insurance payor industry ( Medicare , Medicaid, Commercial, DSNP and other payor ... programs), including legal and regulatory requirements. + Solid understanding of CPT-4, HCPCS, revenue and ICD coding, medical terminology, claims payment, contract negotiations and problem resolution. **Knowledge, Skills and Abilities (KSAs)** + Understanding… more
- Fallon Health (Springfield, MA)
- …hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE- in the region. **Brief ... of summary of purpose:** Responsible for the effective management and delivery of direct nursing care to PACE participants in any setting utilizing nursing process and adhering to standards of nursing practice. **Competencies:** Demonstrates commitment to the… more
- Fallon Health (Worcester, MA)
- …hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive ... Care for the Elderly)- in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The Risk Adjustment Analyst (RAA) will be a SME for the MassHealth risk adjustment model(s) and related data… more
- Hackensack Meridian Health (Edison, NJ)
- …reviews of all Access data elements, such as real time eligibility (RTE), Medicare Payer Secondary Questionnaire (MSPQ), Insurance plan codes, proper sequencing ... of COB (Coordination of Benefits), and reviews physician licensure. Works with Access assigned Work Ques (WQs) to correct the edits causing the stop bills. Included in this is the compilation of edit findings to provide management with a tool to provide… more
- Fallon Health (Springfield, MA)
- …hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE- in the region. **Brief ... summary of purpose:** Performs a variety of duties involving clinical and administrative patient care in accordance with applicable standards of practice. Provides assessment and care to PACE participants at the direction of the SE Clinic Supervisor, SE… more