- Molina Healthcare (Dayton, OH)
- …Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay ... Organization (MCO) or health plan setting, including experience in Medicaid and/or Medicare , or equivalent combination of relevant education and experience + Proven… more
- Aveanna Healthcare (Chandler, AZ)
- Patient Access Representative ( REMOTE ) ApplyRefer a FriendBack Job Details Requisition #: 208490 Location: Chandler, AZ 85286 Category: OT Salary: $17.00 - $18.00 ... insurance companies for a set portfolio of patients. The Patient Access Specialist contacts physicians, practice staff, payer representatives and patients on a daily… more
- Trinity Health (Livonia, MI)
- …modifiers. Utilizes coding guidelines established by: + The Centers for Medicare /Medicaid Services (CMS) ICD-CM Official Coding Guidelines for Coding and Reporting, ... Technician (RHIT), Registered Health Information Administrator (RHIA) or Certified Coding Specialist (CCS) is required. Two (2) years of current acute care… more
- Insight Global (New York, NY)
- …or preferring certifications such as CPCS (Certified Provider Credentialing Specialist ) or CPMSM (Certified Professional Medical Services Management). Industry ... on enrolling providers with multiple payers, including commercial, Medicaid, and Medicare . ○ Proven ability to manage high-volume enrollments (5,000+ enrollments… more
- HonorHealth (AZ)
- …Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of health care services with the ... Responsible for coordinating and conducting medical necessity reviews for all Medicare , AHCCCS, Self-pay, and all other payers, upon admission and concurrently… more
- Trinity Health (Livonia, MI)
- …secondary diagnoses, principal procedure, and secondary procedures. Assigns appropriate Medicare Severity Diagnosis Related Groups (MS-DRG), All Patient Refined DRGs ... Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS) is required. Page 3 3. Three (3) years of… more
- MetroLink (Los Angeles, CA)
- …Annually Location California 90017, CA Job Type At Will Full Time Remote Employment Flexible/Hybrid Job Number 23-2400189 Department Finance Opening Date 10/03/2025 ... your dental services. If you require treatment from a specialist , your contract dentist will handle the referral. Many...exceeds $50,000, be added to your Federal, State, and Medicare taxable earnings for W-2 reporting. This amount is… more
- Texas Health Resources (Arlington, TX)
- …TX 76011 Work Hours: Full Time Days (8:00am-5:00pm) for 40 hrs/week ( remote work allowed at manager's discretion) Department Highlights: + Hybrid Position + ... on emerging expectations. Participate in external regulatory audits, including Medicare , OIG, and non- Medicare denial reviews....Administrator Upon Hire Req Or CCS - Certified Coding Specialist Upon Hire Req Or CPC - Certified Professional… more
- Humana (Burlington, IA)
- …help us put health first** The Care Coach 2 (Transition/Custodial Prevention Specialist ) assesses and evaluates member needs and requirements to achieve and/or ... of moderate complexity. The Care Coach 2 (Transition/Custodial Prevention Specialist ) will meet members in the field at home,...+ Two (2) years of prior experience working with Medicare and Medicaid recipients, long-term care services, Home and… more
- SSM Health (MO)
- **It's more than a career, it's a calling** MO- REMOTE **Worker Type:** Regular **Job Highlights:** **$1,000 sign on bonus available ( Check with recruiter for ... eligibility)** Come join us as a remote Coder II Professional at SSM Health! You will...procedures to obtain. Ensures all coded services meet appropriate Medicare , National Correct Coding Initiative (NCCI) or payer-specific guidelines.… more