- Commonwealth Care Alliance (Boston, MA)
- …This role will ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for ... as necessary on all new and revised coding logic, related Medicare /Medicaid policies for review/approval through the Payment Integrity governance process.… more
- Commonwealth Care Alliance (Boston, MA)
- …accurate, compliant, and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims ... Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare , and commercial payment methodologies and supports audit, compliance, and provider… more
- Molina Healthcare (Oshkosh, WI)
- …for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare -Medicaid recipients within approved ... product features and differences. + Enroll eligible individuals in Molina Medicare products accurately and thoroughly complete and submit required enrollment… more
- Ochsner Health (New Orleans, LA)
- …in applying and improving compliance policies, procedures and processes. Perform Medicare Coverage Analysis (MCA) for sponsored research projects. Configure studies ... Research Compliance (CHRC), Certified Professional Coder (CPC), Certified Coding Specialist (CCS) or related certification. **Knowledge Skills and Abilities (KSAs)**… more
- Sea Mar Community Health Centers (Seattle, WA)
- …by contracted entities such as Accountable Communities of Health and Medicaid/ Medicare organizations. + The TOC Integration Specialist must maintain the ... a mandatory COVID-19 and flu vaccine organization Transition of Care Integration Specialist - Posting #27558 Hourly Rate: $27.32 Position Summary: Sea Mar Community… more
- Corewell Health (Grand Rapids, MI)
- …to come on site at least two times per week. Job Summary The Associate Medicare Star Ratings Quality Improvement Specialist will support the execution of quality ... Michigan Department of Health and Human Services (MDHHS) and Centers for Medicare and Medicaid Services quality metrics and advancing CMS Star Ratings performance.… more
- SUNY Upstate Medical University (Syracuse, NY)
- …Syracuse Inc. (UUMAS) is seeking a Registered Nurse (RN), or Certified Nurse Specialist (CNS), to coordinate and conduct Medicare Annual Wellness Visits (AWVs) ... Primary Care clinic Medical Directors and Nurse Leadership. Duties/Responsibilities: Identify Medicare patients overdue for their Medicare Annual Wellness Visit… more
- Ventura County (Ventura, CA)
- …for Medi-Cal and/or Medicare and prepares reports; + Serves as lead biller/ specialist to the department; and + Performs other related duties as required. Medical ... Medical Billing Specialist III/IV - Behavioral Health Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5037514) Apply Medical Billing … more
- New York State Civil Service (Buffalo, NY)
- NY HELP No Agency Mental Health, Office of Title Medical Specialist 3, Buffalo Psychiatric Center, P27054 Occupational Category Administrative or General Management ... NY Zip Code 14213 Duties Description As a Medical Specialist 3, you would serve as chief of service;...for full and unconditional participation in the Medicaid and Medicare programs.OROpen Competitive:Possession of a license to practice medicine… more
- Ventura County (Ventura, CA)
- Medical Billing Specialist II - Patient Financial Services Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4940099) Apply Medical Billing ... Specialist II - Patient Financial Services Salary $49,302.23 -...for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare , and general insurance reimbursement requirements. The ideal candidate… more