- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Medicaid Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and integrity of ... coordination of analytical processes, investigation and interpretation of Maryland Medicaid risk score methodology, risk score calculation, submissions, enrollment,… more
- AssistRx (Dallas, TX)
- …program business rules. + Strong understanding of Government benefits such as Medicare , Medicaid , and Tricare. + Documenting and reporting payment information. ... DUTIES AND RESPONSIBILITIES: + Processes medical copay claims in accordance with program business rules. +...prescription plans and billing policies to ensure compliance and reimbursement . + Monitor profitability of orders, manage claim queues… more
- Dignity Health (Bakersfield, CA)
- **Job Summary and Responsibilities** The Claims Recovery Manager is responsible for leading the recovery operations within the MSO Claims department. This role ... or GED + Minimum 5 years of progressive experience in healthcare claims recovery, payment integrity, or post-payment audit functions, preferably within a multi-plan… more
- Waystar (Louisville, KY)
- …1K+ hospitals and health systems, and is connected to over 5K commercial and Medicaid / Medicare payers. We are deeply committed to living out our organizational ... of hospital & professional coding and billing workflows and the provider reimbursement process, obtained either through direct experience in a healthcare setting or… more
- Abbott (Austin, TX)
- …and appeal processes and other related matters requiring a specialized knowledge of Medicare , Medicaid and Private Payer reimbursement procedures and ... ** is responsible for implementing and managing clinical trial reimbursement processes to secure Medicare and private...On** + Review clinical investigative plan and payer policies ( Medicare , Medicare Advantage, Medicaid and… more
- New York State Civil Service (Albany, NY)
- …May serve as subject matter expert (SME) for the following subject/program areas: Medicaid , SSI, Social Security, Medicare , Food Stamps, Outside Hospital Care ... NY HELP Yes Agency Mental Health, Office of Title Resources & Reimbursement Agent 1/Trainee 1&2 (NYS HELPS), Central Office; Occupational Category Financial,… more
- J&J Family of Companies (Portland, ME)
- …approval processes and business acumen + Understanding of Medicare , Medicaid , and private payer initiatives affecting reimbursement of pharmaceutical and ... assigned. Educate HCPs on product coverage, prior authorizations and appeals, reimbursement processes, claims submissions, procedures, and coding requirements of… more
- J&J Family of Companies (Milwaukee, WI)
- …approval processes and business acumen. + Understanding of Medicare , Medicaid , and private payer initiatives affecting reimbursement of pharmaceutical and ... + Educate HCPs on product coverage, prior authorizations and appeals, reimbursement processes, claims submissions, procedures, and coding requirements of… more
- Fairview Health Services (Minneapolis, MN)
- …Medical Billing + 3 years Three+ years medical billing or collection experience, Medicare , Medicaid , Third Party experience + Pharmacy Technician MN Certified ... Ensure accurate and timely billing, collections, appeal of home infusion claims . Perform collection tasks to obtain payments. Analyze accounts for documentation,… more
- Danaher Corporation (Portland, OR)
- …and reimbursement landscape. + Communicate regional and local coverage and reimbursement issues for Medicare , Medicaid and Commercial payers through ... and reimbursement . + Support customers with approved resources for denied claims , payer coverage expansion and inadequate reimbursement . + Respond to and… more