- Redeemer Health Home Care & Hospice (Meadowbrook, PA)
- …(InterQual, , etc.). Strong knowledge ofManaged Care, Medical Assistance and Medicare reimbursement required. Ability to perform duties and documentation ... per departmental, DNV, PA Department of Health and other healthcare requirements. Working knowledge of PA. Laws impacting health care delivery, ie Advance Directives, Guardianship, Abuse and Neglect and of community resources. Demonstrates knowledge and… more
- Houston Methodist (Houston, TX)
- …outs, new procedures, new drugs. Analyzes proposals which include capitation reimbursement , Medicare resource-based revenue value scale (RBRVS) values, current ... maintenance and payer relations of the Houston Methodist (HM) contracts for reimbursement of services billed through managed care companies and serves as a… more
- The Cigna Group (Bloomfield, CT)
- …position will provide external actuarial analytics support within the regulated Medicare market and Pharmacy Benefit Manager (PBM) Healthplan space. This actuarial ... a designated full time support to Express-Script's external client's Medicare Part D business. This role will matrix with...401(k) with company match, company paid life insurance, tuition reimbursement , a minimum of 18 days of paid time… more
- RWJBarnabas Health (Oceanport, NJ)
- Inpatient Coding Quality Officer III - ( Medicare ) RemoteReq #:0000183242 Category:Coder Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services ... 07757 Job Title: Inpatient Coding Quality Officer III - ( Medicare ) Location: Barnabas Health Corp Department: HIM - Coding...timely manner, there is a detrimental impact to the reimbursement flow for the facility (DNB). + Productivity Standards… more
- Community Health Systems (La Follette, TN)
- …and assists in resolving claim discrepancies to reduce denials and ensure proper reimbursement . **Essential Functions** + Prepares and submits Medicare claims in ... **Job Summary** The Medicare Billing Specialist is responsible for performing timely...Billing Specialist is responsible for performing timely and accurate Medicare billing activities, including claims preparation, eligibility verification, census… more
- State of Indiana (Indianapolis, IN)
- Medicaid/ Medicare Coordination Manager Date Posted: Sep 5, 2025 Requisition ID: 464717 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling ... is fully engaged with this mission. Role Overview: In this role, Medicaid/ Medicare Coordination Manager, you will establish priorities, targets, and deadlines for… more
- Prime Therapeutics (Harrisburg, PA)
- …our passion and drives every decision we make. **Job Posting Title** Mgr Medicare Part D Pharmacy Programs - Remote, Pennsylvania **Job Description** Manages the ... coordination of benefits in the pharmacy program with Medicare Part D plans. Provides the technical and leadership...not limited to premium amounts, late enrollment penalties, and reimbursement of drug claims. + Ensures the accuracy of… more
- Centene Corporation (Houston, TX)
- …to competitive benefits including a fresh perspective on workplace flexibility. ** Medicare Field based sales position for Houston, TX** **Bilingual English/Spanish** ... access to health insurance, by providing education and assistance to Medicare individuals. Distribute health education materials and arrange for health screenings.… more
- AdventHealth (Maitland, FL)
- …Senior Compliance Analyst will have expertise in Commercial and Governmental ( Medicare , Medicaid, Tricare) payer reimbursement language and methodologies. The ... + Facilitate resolution to contract violations by leveraging knowledge of Medicare Advantage plans regulatory requirements and Medicare Advantage Appeal… more
- Gentiva (St. Louis, MO)
- …sales/management experience, preferably in hospice or healthcare + Experience with Medicaid/ Medicare regulations and reimbursement + Strong understanding of ... performance improvement + Drive clinical quality and ensure services meet Medicare Conditions of Participation, state hospice regulations, and Gentiva standards +… more