- Hunterdon Health Care System (Flemington, NJ)
- …productive, goal-oriented manner + Preferred: + Knowledge of managed healthcare plans, Medicare and Medicaid regulations. Knowledge of NextGen- software's coding ... maintenance of medical necessity software, insuring compliance relating to Medicare billing requirements, conducting internal audits relating to medical necessity,… more
- New York State Civil Service (Albany, NY)
- …eligible and maintain eligibility for full and unconditional participation in the Medicare and Medicaid programs. Continued employment will depend on maintaining ... Duties Description The Research Scientist 2 position will work within the Bureau of Medicaid Data Reporting and Analysis and will assist in a broad range of… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …you'll leverage your knowledge of risk adjustment and healthcare data (primarily Medicare Advantage, Medicaid , and ACA Commercial), looking for trends within ... the enterprise. The ideal candidate will have experience with risk adjustment, Medicare Advantage, Medicaid , ACA commercial, clinical coding, SQL, Power BI… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …adjustment issues. The ideal candidate will have experience with Encounter Data, Medicare Advantage, Medicaid , ACA commercial, and clinical coding, possess a ... Experience * Encounter Data submissions experience with a focus on ACA, Medicaid and / or Medicare Advantage. * Knowledge of CMS ACA EDGE, Medicare Advantage… more
- Molina Healthcare (Omaha, NE)
- …representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). M-F from 8am - 4:30pm EST ... coordination of benefits (COB), subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and… more
- Banner Health (Phoenix, AZ)
- …Hospital leadership. Will direct the preparation of rate filings to Centers for Medicare and Medicaid Services (CMS), Health and Human Services (HHS), Arizona's ... needed. Knowledge of health care and state government, familiarity with Medicaid , Commercial and Medicare related products. Demonstrated leadership capabilities,… more
- Molina Healthcare (Kenosha, WI)
- …Act** cases in accordance with the standards and requirements of Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Responsible for ... coordination of benefits (COB), subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and… more
- Molina Healthcare (Houston, TX)
- …in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Manages team ... complicated claims, COB and DRG/RCC pricing). * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory… more
- Marshfield Clinic (Wisconsin Rapids, WI)
- …months of hire. + Certified Application Counselor designation through the Centers for Medicare and Medicaid Services within three months from the first fall ... hire. + Certified Application Counselor designation through the Centers for Medicare and Medicaid Services at time of hire. **Marshfield Clinic Health System is… more
- Cognizant (St. Johns, FL)
- …10 to 12 years of expertise in FileNet P8 technologies and domain skills in Medicare and Medicaid Claims. The candidate will play a crucial role in designing ... to ensure seamless data management and retrieval. + Analyze and interpret Medicare and Medicaid Claims data to identify areas for process improvement. + Provide… more