• Payer Manager

    AdventHealth (Maitland, FL)
    …review and interpretation of Insurance Provider Manuals, payment methodologies, and reimbursement rates. Maintains a strong working knowledge of federal government ... for Florida and multi-state hospital providers, with a concentration on Medicare , state specific Medicaid, non-contracted payers, and Tricare. Consults with key… more
    AdventHealth (09/09/25)
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  • Payment Integrity Program Manager - Health Plan…

    Molina Healthcare (San Diego, CA)
    …achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for ... of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape recommendations and action plans. +...At least 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization… more
    Molina Healthcare (08/08/25)
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  • Mental Health Program Manager III / Emergency…

    The County of Los Angeles (Los Angeles, CA)
    …meet State and Federal mandated standards and are in compliance comply with Medicare and Medi-Cal rules for reimbursement claiming. Oversees revenue generation ... DEPARTMENT CONTACT: HR Examinations Unit: ### HR Examinations Unit Email: ###@dmh.lacounty.gov Analyst Contact Phone: Irene San, ### Analyst Contact Email:… more
    The County of Los Angeles (09/08/25)
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  • Executive Director, Data Analytics & Verification

    City of New York (New York, NY)
    Job Description APPLICANTS MUST BE PERMANENT IN THE ADMINISTRATIVE STAFF ANALYST CIVIL SERVICE TITLE OR IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9. The Department of ... Analytics & Verification is recruiting for (1) Administrative Staff Analyst NM III to function as an Executive Director,...and implement the process to evaluate claims for skimming reimbursement in a batch, data-driven manner, with 100% accuracy… more
    City of New York (08/13/25)
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  • AHD Minimum Data Set (MDS) Coordinator - PB

    Alameda Health System (Alameda, CA)
    …DME, SNF, and transportation; and referring personal payment issues to the Financial Analyst as soon as possible to minimize reimbursement . Obtains appropriate ... Assigns, assists, and instructs all staff in the RAI Process, Case-Mix, PPS Medicare , Medicaid, and the clinical computer system in relation to these processes. 8.… more
    Alameda Health System (08/08/25)
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  • Customer Solution Center Audit Readiness…

    LA Care Health Plan (Los Angeles, CA)
    …Care Services (DHCS), Department of Public Social Services (DPSS), Centers for Medicare and Medicaid Services(CMS), LACC - CalHers, and National Committee for ... for continuous process improvements. Collaborates with Customer Solution Center Business Analyst to track, trend, and analyze results of Quality Assurance (QA)… more
    LA Care Health Plan (07/17/25)
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  • Facility Coding Inpatient Complex Coder

    Banner Health (WY)
    …information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or ... treatment information or documentation to coding support tech, coding quality analyst or coding manager for clarification/additional information for accurate code… more
    Banner Health (09/10/25)
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  • Director of Administration

    City of New York (New York, NY)
    …Benefits Program, Management Benefits Fund, Employee Assistance Program, Work Well NYC, Medicare Part B Reimbursement and Pre-Tax Benefits & Citywide Programs ... Relations Administration Division is seeking to hire Associate Labor Relations Analyst , reporting directly to the Assistant Commissioner of Administration and… more
    City of New York (09/06/25)
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  • Clinical Documentation Specialist Trainee

    Prime Healthcare (Harlingen, TX)
    …traits to facilitate ongoing physician communication. 12. Working knowledge of Medicare reimbursement system and coding structures preferred. Employment Status ... , sometimes referred to as a Medical Records Documentation Analyst - Trainee , or CDS Trainee in our...other leave options + Employer 401K options + Tuition reimbursement options + Life, disability, and other insurance options… more
    Prime Healthcare (09/10/25)
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  • Physician-based Oncology Senior Complex Coder

    Banner Health (KY)
    …information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or ... and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health… more
    Banner Health (09/05/25)
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