- Bristol Myers Squibb (Princeton, NJ)
- …accounts, oncology networks, provider accounts and patient access + Experience in Medicare inpatient and outpatient reimbursement strongly preferred + Proven ... enterprise account lead. + Monitor and assess CAR T reimbursement trends through policy updates and ongoing analysis of...payer contracting, and health economics + Deep understanding of Medicare and Medicaid policies related to CAR… more
- Huron Consulting Group (Chicago, IL)
- …(CDC), ICD-CM Official Coding Guidelines for Coding and Reporting, Centers for Medicare / Medicaid Services (CMS) ICD-PCS Official Guidelines for Coding and ... and Patient Financial Services (PFS) teams, when needed, to help resolve billing, claims , denial and appeals issues affecting reimbursement . * Maintains CEUs as… more
- General Dynamics Information Technology (Fairfax, VA)
- …As a Healthcare Coding Subject Matter Expert (SME) supporting the Centers for Medicare and Medicaid (CMS), you will be trusted to research healthcare ... Party activities. **Roles and Responsibilities** + Reviews and analyzes medical claims to determine accuracy, completeness and compliance with insurance policies,… more
- Centene Corporation (Tallahassee, FL)
- …healthcare organization, and medical claims . Knowledge of health care, managed care, Medicare or Medicaid .Pay Range: $22.79 - $38.84 per hour Centene offers ... up accurately in the provider information system for state reporting, claims payment, and directories. Responsible for multiple state deliverables, network reporting… more
- Ellis Medicine (Schenectady, NY)
- …and reconcile deposit slips. + Review Billing Exception Report for Revenue Management, the Medicare system (FISS), and the claims scrubber (SSI) daily for data ... Review and resolve outstanding accounts receivable with insurance companies and patients. + Claims in dispute with payers are reviewed daily to ensure the provider… more
- CVS Health (Phoenix, AZ)
- …PBMs, including HIPAA, HHA licensing, Medicare , Medicaid (including Medicare / Medicaid billing and reimbursement issues), nurse licensing, patient ... a role with working knowledge of healthcare laws and regulations, the False Claims Act, and the Federal Anti-Kickback Statute. + Excellent drafting and negotiation… more
- AmeriHealth Caritas (West Chester, PA)
- …software support preferred. + Knowledge/experience with government market lines of business ( Medicaid , Medicare ) is preferred. ;Some knowledge/ experience with ... execute production schedules, ensuring timely and accurate processing of claims while maintaining a focus on cost efficiency +...Medicaid / Medicare LTSS (Long Term Services & Support) government product… more
- Centene Corporation (Jefferson City, MO)
- …Enterprise Business Operations Services (EBOS) provides shared operational services across our Medicaid , Marketplace, and Medicare lines of business and markets. ... scale / healthcare payer provider data management processes highly preferred. Including Medicaid , Marketplace, and Medicare lines of business Pay Range:… more
- Care Initiatives (Waterloo, IA)
- …business office functions, including Accounts Receivable (AR), Accounts Payable (AP), resident billing, Medicare / Medicaid , and insurance claims . + Maintain ... collections in a healthcare or long-term care setting. + Familiarity with Medicare , Medicaid , and insurance reimbursement processes . + Strong organizational… more
- AmeriHealth Caritas (Newtown Square, PA)
- …program strategy and performance across all ACFC lines of business and products ( Medicaid , Medicare , Exchange, PBM, BH). This role ensures that implemented ... engagement strategies that promote transparency and trust throughout the claims auditing process + Act as a liaison between...+ Working knowledge of CMS guidance and experience with Medicaid + Working knowledge of payment integrity regulations and… more