• 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 ... understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape recommendations and action plans. + Translates… more
    Molina Healthcare (08/08/25)
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  • Dietitian I - Food Nutrition Services Evergreen

    PeaceHealth (Florence, OR)
    …+ Current licensure/certification as required by State. + Registered Dietitian Current Medicare provider status number may be required. + Position may require valid ... license and auto insurance. + Certified Diabetes Care and Education Specialist (CDCES), or Certified Nutrition Support Clinician, or Board-Certified Specialist more
    PeaceHealth (09/01/25)
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  • Prior Authorization Technician - Remote

    Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
    …Remote Position Type Full Time Job Category Pharmaceutical Description PRIOR AUTHORIZATION SPECIALIST (REMOTE) WHO WE ARE Polaris Pharmacy Services is an industry ... Authorization Technicians to join the Polaris team. OVERVIEW The Prior Authorization Specialist is responsible for managing and identifying a portfolio of rejected… more
    Polaris Pharmacy Services, LLC (09/11/25)
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  • Senior Resident Account Specialst

    St. John's Embrace Living (Rochester, NY)
    Position Summary: The Senior Resident Billing Specialist position reports directly to the Director of Revenue Cycle Management and will assist in the resident ... and revenue collections + New York State Medicaid and Medicare rules and regulations + Basic methods and procedures...+ Regularly meet with supervisor to discuss and resolve reimbursement issues or billing obstacles; + Meets with Elders… more
    St. John's Embrace Living (08/29/25)
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  • Utilization Review Manager

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …when appropriate * Collaborates with department director and professional development specialist to develop standard work and expectations for the utilization review ... compliance to regulatory and health plan requirements for authorization, including Medicare Inpatient Only List and communicates to provider to obtain accurate… more
    Minnesota Visiting Nurse Agency (08/08/25)
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  • NP/PA - University Internist @ Paul Cohen's Office

    SUNY Upstate Medical University (Syracuse, NY)
    …professionals and medical facilities + Communicate with collaborating physician or specialist regarding patient care Provides exemplary patient care Timely and ... of certification must be consistent with practice). Must have NPI number and be Medicare Enrolled with Medicare Identification Number (or PTAN) OR be eligible… more
    SUNY Upstate Medical University (07/16/25)
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  • PT Registration Spec - ED

    Covenant Health Inc. (Knoxville, TN)
    Overview Patient Registration Specialist , Emergency Department Full Time, 72 Hours Per Pay Period, Night Shift Fri, Sat, Sun 530p-6a every week. Emergency Dept ... package (https://www.covenantcareers.com/benefits) , including: offering unmatched medical insurance, tuition reimbursement ; student loan repayment assistance, certification bonuses; leadership and… more
    Covenant Health Inc. (08/28/25)
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  • Quality Assurance Nurse LTC

    Centene Corporation (Queens, NY)
    …Teams and / or activities / clinical documentation submitted by the Intake Specialist . The Clinical Quality Assurance RN will review for to confirm accuracy and ... (CDOH), Local Department of Social Services and Center for Medicare & Medicaid Services (CMS). The Clinical Quality Assurance...will spend time in the field while reviewing Intake Specialist work and will actively coach and develop staff… more
    Centene Corporation (08/27/25)
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  • Supervisor, Education/Audit, Physician Billing

    Hackensack Meridian Health (Edison, NJ)
    …conducts audits for medical provider documentation while adhering to Centers for Medicare and Medicaid Services (CMS) and Office of Inspector General (OIG) ... coding and auditing concepts, American Medical Association (AMA)/Centers for Medicare and Medicaid Services (CMS)/Office of Inspector General (OIG)/Federal/State… more
    Hackensack Meridian Health (08/21/25)
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  • Dietitian I/Dietitian II - Inpatient Nutrition…

    PeaceHealth (Ketchikan, AK)
    …be able to design, implement, and evaluate instructional materials. + Current Medicare provider status number may be required. + Registered Dietitian or registration ... 3 years in a related setting as a Registered Dietitian** + Current Medicare provider status number may be required. + Registered Dietitian or registration eligible… more
    PeaceHealth (08/08/25)
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