- Molina Healthcare (Rockford, IL)
- Molina Healthcare is hiring a Sr Specialist in our Government Contracts department. This role is remote with a high preference for candidates who reside in ... Illinois. The Sr Specialist in our Government Contracts will be responsible for...of contracts with State and/or Federal governments for Medicaid, Medicare , Marketplace, and other government-sponsored programs to provide health… more
- Staffing Solutions Organization (Albany, NY)
- …Populations** **Training will be 100% In-Office and will move to a 50% Remote Schedule.** **Duties:** The Senior Healthcare Program Specialist (level 2 or ... a reflection of our clients and the people they serve. **Senior Healthcare Program Specialist (Level 2 or 3) in Albany, NY** **Division of Eligibility & Marketplace… more
- Cognizant (Malvern, PA)
- …flexibility wherever possible. Based on this role's business requirements, this is a remote position open to qualified applicants in the United States. Regardless of ... a healthy work-life balance though our various wellbeing programs. **Location:** Remote (Work-from-Home) **Schedule:** Monday to Friday 8am - 4:30pm ET… more
- Actalent (Dallas, TX)
- Job Title: Specialist , Appeals & GrievancesJob Summary: Responsible for reviewing and resolving member and provider complaints and communicating resolutions. Key ... of benefits, and eligibility + Familiarity with Medicaid and Medicare regulations + Strong written and verbal communication skills...and verbal communication skills + Ability to work fully remote , equipment provided Pay and Benefits The pay range… more
- Centene Corporation (Frankfort, KY)
- …reports to monitor network compliance with State requirements. The Provider Data Management Specialist I position is primarily remote , with an expectation to ... enrollment specifications and demographic changes + Update delegated provider Medicare and Medicaid documents on a monthly and ad...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
- Integra Partners (Troy, MI)
- JOB OVERVIEW Our Claims Resolution Specialist role is responsible for reviewing Durable Medical Equipment (DME) claims for billing accuracy while maintaining ... cycle objectives + Stay informed on product information, changes in Medicare /State/Contract funding procedures, and updates in policies and procedures + Contribute… more
- Ochsner Health (Morgan City, LA)
- …Required - None. Preferred - Certified Provider Credentialing Specialist and/or Certified Professional Medical Services Management certification. **Knowledge ... Medical Staff Standards of The Joint Commission, Centers for Medicare & Medicaid Services or Credential Management System (CMS)...determine whether the position you are interested in is remote or on-site._** _Individuals who reside in and will… more
- US Tech Solutions (Monroeville, PA)
- **Position Summary:** + Billing Specialist I will be responsible for qualifying, preparing and submitting claims to Medicare Part B, Major Medical and Medicaid. ... ON RESUME as on site work may be required.(Currently remote - but worker will eventually be coming on site...THIS IS ONSITE AS NEEDED: Currently the position is remote but until their equipment is in they are… more
- Highmark Health (Charleston, WV)
- …organizations and leaders. + Build an understanding of SDOH, Managed Care issues, Medicare , Medicaid, Dual Special Needs and delivery of those services to the ... with outside entities regularly to learn of community needs. + Collaborate with Medicare Sales team to identify enrollment opportunities. + Other duties as assigned… more
- BJC HealthCare (St. Louis, MO)
- …About the Role** BJC HealthCare has an opportunity for an Audit Compliance Specialist . This role is responsible for managing pay audit requests from managed care ... organizations, Medicare , Medicaid, and VA to ensure accurate payments and...and procedure types, distinguishing between valid and invalid charges. Remote position, must reside in the Greater St. Louis… more