• Medicare / Medicaid Claims Editing…

    Commonwealth Care Alliance (Boston, MA)
    …This role will ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible ... research, as necessary on all new and revised coding logic, related Medicare / Medicaid policies for review/approval through the Payment Integrity governance… more
    Commonwealth Care Alliance (11/25/25)
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  • Sr Medicare Medicaid Biller…

    Prime Healthcare (Redding, CA)
    …family. For more information, visit www.shastaregional.com. Responsibilities The Senior Medicare - Medicaid Biller/Collector is responsible for both billing and ... the specific payer guidelines, policies, procedures, and compliance regulations for Medicare - Medicaid . This includes maintaining the deficiency lists used to… more
    Prime Healthcare (11/25/25)
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  • Senior Medicare Medicaid Biller…

    Prime Healthcare (Inglewood, CA)
    …new members to join our corporate team! #LI-JV1 Responsibilities The Senior Medicare - Medicaid Biller/Collector is responsible for both billing and collections, ... the specific payer guidelines, policies, procedures, and compliance regulations for Medicare - Medicaid . This includes maintaining the deficiency lists used to… more
    Prime Healthcare (11/25/25)
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  • Patient Account Representative - Medicare

    Guidehouse (Lewisville, TX)
    …from home._** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare / Medicaid + Insurance Follow-up + Customer Service + Billing + UB-04 & ... CMS 1500 + Complete all business-related requests and correspondence from patients and insurance companies. + Responsible for working on 40-70 Accounts Per Day + Complete all assigned projects in a timely manner. + Assist client and patients in all requested… more
    Guidehouse (11/09/25)
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  • Clinical Program Coordinator RN, Medicare

    Providence (Beaverton, OR)
    …empower them.** **Providence Health Plan is calling a Clinical Program Coordinator RN, Medicare / Medicaid who will:** + Provide care coordination, case ... management and care management services to Providence Health Plans(PHP) members + Care coordination services include: disease management programs, including educating, motivating and empowering members to manage their disease + Case management services… more
    Providence (10/24/25)
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  • VP Government Programs - Medicare & Managed…

    Prime Therapeutics (Salem, OR)
    …drives every decision we make. **Job Posting Title** VP Government Programs - Medicare & Managed Medicaid (REMOTE) **Job Description** The Vice President ... Government Programs - Medicare & Managed Medicaid is responsible for the development, administration, and execution of strategic plans that advance Prime's… more
    Prime Therapeutics (10/08/25)
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  • Senior Medicaid & Medicare

    OhioHealth (Columbus, OH)
    …**Job Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This ... position will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid ) reimbursement is received for OhioHealth. * This position is… more
    OhioHealth (09/25/25)
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  • Medicare / Medicaid Claims…

    Commonwealth Care Alliance (Boston, MA)
    …disputes. The Claims Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare , and commercial payment methodologies and supports audit, ... accurate, compliant, and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims… more
    Commonwealth Care Alliance (08/31/25)
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  • Actuary

    Centers for Medicare & Medicaid Services (Woodlawn, MD)
    …position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Office of the Actuary. As a Actuary, ... serves as a technical and actuarial expert for the modeling of Medicare and/or Medicaid program rates and estimates for both services covered under current law… more
    Centers for Medicare & Medicaid Services (11/22/25)
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  • Special Assistant

    Centers for Medicare & Medicaid Services (Woodlawn, MD)
    …position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare (CM), Medicare ... tasks on complex activities and issues pertaining to the Medicare prescription drug benefit. Consult and advise the Group...sector, to include: Coordinating projects and tasks on the Medicare Part D prescription drug benefit or on quality… more
    Centers for Medicare & Medicaid Services (11/21/25)
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