• Pre-Arrival Scheduling Specialist I

    UNC Health Care (Goldsboro, NC)
    **Description** Summary: The Pre-Arrival Scheduling Specialist I will serve patients/customers and physician offices by obtaining a valid physician order to schedule ... education from an accredited college will supersede this requirement. Licensure/ Certification None required. Experience .Prior experience with Scheduling/Customer Service,… more
    UNC Health Care (07/30/25)
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  • Operation Specialist

    Beth Israel Lahey Health (Burlington, MA)
    …line with payer expectations, contributing to favorable revenue cycle. The Operational Specialist position will have an impact on provider, patient, and staff ... insurance authorizations as needed. . Identifies potential payment issues with Medicare and other payers and communicates and/or resolves issues as appropriate… more
    Beth Israel Lahey Health (07/30/25)
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  • Clinical Doc Improvement Specialist

    Queen's Health System (Honolulu, HI)
    …subjected to adverse environmental conditions. IV. MINIMUM QUALIFICATIONS: A. EDUCATION/ CERTIFICATION AND LICENSURE: * Current Hawaii State license as a ... or evidence of good driving record. * Current BLS certification . B. EXPERIENCE: * Minimum one (1) year experience...clinician (RN). * One (1) year experience in a Medicare Certified home health agency. * Working knowledge of… more
    Queen's Health System (10/02/25)
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  • Remote Inpatient Coding Specialist

    AdventHealth (Altamonte Springs, FL)
    …record, applying appropriate ICD-10-CM/PCS coding conventions and MS-DRG Medicare Prospective Payment System requirements. Actively participates in outstanding ... ICD-10-CM rules and conventions, coding policy and procedures, requirements of Medicare / payer specifications, and official coding guidelines as outlined by… more
    AdventHealth (10/10/25)
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  • Specialist , Government Contracts (Remote…

    Molina Healthcare (Salt Lake City, UT)
    …**Preferred Experience** 2+ years compliance related experience. 1+ years in Medicare . **Preferred License, Certification , Association** N/A To all current ... administration of contracts with State and/or Federal governments for Medicaid, Medicare , Marketplace, and other government-sponsored programs to provide health care… more
    Molina Healthcare (08/29/25)
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  • Clinical Documentation Specialist

    Brockton Hospital (Brockton, MA)
    …profiling, and reimbursement. + Knowledge of pathophysiology and disease process; Medicare Part A and B knowledge of regulatory environment. + Understanding ... and ability to communicate the differences between Medicare Part A and Part B guidelines and how they impact DRG assignments. + Organizational, analytical, writing,… more
    Brockton Hospital (09/25/25)
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  • Registered Nurse (RN) Specialist , Critical…

    Molina Healthcare (Roswell, NM)
    …improvement, managed care, or equivalent experience **Required Licensure or Certification :** + RN **Required Knowledge, Skills, and Abilities:** + Demonstrated ... Qualifications** + Experience in Clinical Quality, Public Health, Healthcare, Waiver Services ( Medicare /Medicaid). 5+ years of experience in Medicare and in… more
    Molina Healthcare (09/21/25)
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  • Professional Billing Credentialing…

    Queen's Health System (Honolulu, HI)
    …credentialing packages as required by hospitals, surgery centers, commercial payors, Medicare and Medicaid. * Performs credentialing in accordance with policies and ... common to a hospital and office environment. IV. MINIMUM QUALIFICATIONS: A. EDUCATION/ CERTIFICATION AND LICENSURE: * High school diploma or equivalent education. *… more
    Queen's Health System (09/09/25)
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  • Value-Based Reimbursement Specialist

    Highmark Health (Montpelier, VT)
    …share and risk share models and will be implemented for the Organization's Medicare Advantage, Medicaid, ACA, and commercial populations with the goal of maximizing ... interpretation, and outcomes strategic plan development. + 1 year experience with Medicare STARS, Medicaid HEDIS, risk revenue value streams, and population health… more
    Highmark Health (08/20/25)
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  • Clinical Nurse Specialist - Home Health…

    Virtua Health (Marlton, NJ)
    …of America) Total Weekly Hours: 40 Additional Locations: Job Information: *Current board certification as WOC (ET) nurse (CWOCN) by the Wound, Ostomy and Continence ... Nursing Certification Board or presently enrolled in WOCN accredited ET...our nursing culture. Virtua Home Care is a large, Medicare -certified home health agency that provides multidisciplinary skilled services… more
    Virtua Health (09/23/25)
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