• EAP Specialist - Hybrid

    UPMC (Pittsburgh, PA)
    UPMC's Health Plan and WorkPartners are hiring an EAP Specialist for their LifeSolutions Clinical Services Team. This is a hybrid role that will work partially ... the direction of LS Clinical Director and/or the Medical Director, the EAP Specialist is responsible for providing the clinical services for the Employee Assistance… more
    UPMC (11/14/25)
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  • Coding Account Resolution Specialist

    HCA Healthcare (Nashville, TN)
    …Submit your application for the opportunity below:Coding Account Resolution Specialist -OutpatientParallon **Benefits** Parallon offers a total rewards package that ... benefits may vary by location._** We are seeking a Coding Account Resolution Specialist -Outpatient for our team to ensure that we continue to provide all patients… more
    HCA Healthcare (10/30/25)
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  • *Revenue Integrity Specialist (Clinical…

    Henry Ford Health System (Troy, MI)
    …SUMMARY: Reporting to the Manager, Revenue Integrity, the Revenue Integrity Specialist identifies revenue opportunities and works collaboratively with Revenue Cycle ... other more senior Revenue Integrity leaders, the Revenue Integrity (RI) Specialist is responsible for multiple Revenue Integrity initiatives involving multiple… more
    Henry Ford Health System (10/23/25)
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  • Regulatory Specialist

    Covenant Health Inc. (Morristown, TN)
    Overview Regulatory Specialist , Quality Management Full Time, 80 Hours Per Pay Period, Day Shift Some local travel required.Some weekend,holiday or night coverage ... The Joint Commission, CMS, and other regulatory/licensing agencies. The Regulatory Specialist is responsible for maintaining current knowledge of all applicable… more
    Covenant Health Inc. (10/22/25)
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  • Medical Billing Specialist

    Robert Half Accountemps (Johnston, IA)
    Description We are looking for a skilled Medical Billing Specialist to join our team in Johnston, Iowa. In this long-term contract position, you will play a critical ... to ensure timely and accurate claim submissions. * Stay informed about Medicare and Skilled billing regulations to maintain compliance. * Manage co-insurance… more
    Robert Half Accountemps (11/26/25)
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  • Utilization Review Specialist Nurse (RN)…

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... of local and national coverage determinations + Comprehensive knowledge of Medicare , Medicaid, and Managed Care requirements + Comprehensive knowledge of community… more
    Houston Methodist (11/02/25)
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  • Quality Assurance Specialist /Certified…

    WestCare Foundation (Pikeville, KY)
    …for assisting the agency in ensuring that documentation requirements for Medicaid, Medicare and other funding sources per chapter and contract guidelines are adhered ... in the areas of quality documentation and records review in relation to Medicaid/ Medicare regulations and all other federal, state and local rules and regulations… more
    WestCare Foundation (10/23/25)
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  • Regulatory Licensing Specialist

    Ochsner Health (New Orleans, LA)
    …concurrently to meet required standards and deadlines, and maintaining Medicare certifications/enrollments and Medicaid enrollments for all facilities. In addition, ... Research Compliance (CHRC), Certified Professional Coder (CPC), or Certified Coding Specialist (CCS) **Knowledge Skills and Abilities (KSAs)** + Strong analytical… more
    Ochsner Health (10/16/25)
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  • Case Management Specialist

    CVS Health (Harrisburg, PA)
    …member of our Special Needs Plan (SNP) care team, the telephonic Care Manager Specialist (CMS) plays a key role in coordinating the care of our members, particularly ... or willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care. + **Community Resources:** Familiarity with community… more
    CVS Health (11/26/25)
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  • HIM Audit Specialist / PB Coding

    Hartford HealthCare (Farmington, CT)
    …other common practices across the system.*__* *_Position Summary:_* The Audit Specialist is responsible for reviewing clinical documentation to determine appropriate ... 2. Researches literature from regulatory groups such as; HHS/OIG, Medicare , Medicaid, NGS, etc., professional and peer organizations' practices/policies/guidelines… more
    Hartford HealthCare (11/24/25)
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