• Medicaid Subject Matter Expert/Data…

    DATAMAXIS (Springfield, IL)
    …working in projects like the following: CMS Federal Reporting, quality measures, claims processing, Medicaid program eligibility , provider enrollment, ... stakeholders to make determinations relating to complex processes involving claims processing/adjudication, recipient/provider eligibility , and third-party liability.… more
    DATAMAXIS (10/22/25)
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  • Medicaid Insurance Billing And Follow…

    TEKsystems (West Des Moines, IA)
    …accurately transmitted daily and all appropriate documentation is sent when required + Verify eligibility and claims status on unpaid claims + Provide timely ... is supporting the automation within the business office. Prior experience within Medicaid is required. Description The Insurance Billing and Follow Up Specialist more
    TEKsystems (01/05/26)
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  • Eligibility and Operations…

    CVS Health (Columbus, OH)
    …or at risk for involvement in, multiple child-serving systems. **Position Summary** The ** Eligibility and Operations Specialist ** plays a key role in managing ... eligibility and CME ( _Care Management Entity_ ) enrollment issues. The ** Eligibility and Operations Specialist ** will provide support on a wide range of… more
    CVS Health (12/31/25)
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  • Medical Billing Specialist III/IV…

    Ventura County (Ventura, CA)
    Medical Billing Specialist III/IV - Behavioral Health Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5037514) Apply  Medical Billing ... Specialist III/IV - Behavioral Health Salary $54,060.11 - $76,162.64...IV), performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance… more
    Ventura County (12/17/25)
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  • Eligibility Specialist

    Constructive Partnerships Unlimited (Manhattan, NY)
    Eligibility Specialist Type of Position Full time Search Location(s) Manhattan, NY Apply Now ... (https://phe.tbe.taleo.net/phe03/ats/careers/v2/applyRequisition?org=CPOFNYS&cws=37&rid=6455) Job Brief Responsible for preparing Medicaid and Social Security Administration (SSA) recertifications; completing representative… more
    Constructive Partnerships Unlimited (11/06/25)
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  • Billing Specialist

    Masonicare (Wallingford, CT)
    Medicaid and Commercial Primary/Secondary beneficiaries. Submits third party claims and resolves billing, payment and collection issues. Essential Duties and ... Billing Specialist Job Location: Wallingford Center, Connecticut Billing ...performs a variety of complex operations related to the eligibility , claim preparation, claim submission, suspense resolution, claim follow… more
    Masonicare (12/09/25)
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  • Nursing Home Billing Specialist

    Teresian House (Albany, NY)
    …Teresian House in your choice for employment! The Nursing Home Billing Specialist is responsible for: + Timely insurance verification of all referrals for ... billing of all services rendered to residents in compliance with NYS Medicaid , Medicare, Mafae Care Organizations (MCO's) and private insurance. + Preparing and… more
    Teresian House (01/02/26)
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  • Specialist , Appeals & Grievances

    Molina Healthcare (ID)
    …of benefits (COB), subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of ... JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to… more
    Molina Healthcare (01/15/26)
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  • HDM-OP Pharmacy FS Specialist - Specialty…

    Rush University Medical Center (Chicago, IL)
    …compliance with payer and regulatory requirements. The position verifies insurance eligibility , reviews benefits, prepares routine billing reports, and prepares and ... patient balance collections. **Responsibilities** + Prepares and submits medical claims weekly for Oncology, Infertility, Cystic Fibrosis, Transplant, and Pulmonary… more
    Rush University Medical Center (01/10/26)
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  • Compliance Specialist 2 (07026,08041)

    State of Montana (Helena, MT)
    …experience. /**/ *Qualifications for this Career Opportunity ** * Knowledge of Medicaid rules, medical claims processing, medical terminology and coding ... the Office of Inspector General, Program Compliance Bureau.* The Compliance Specialist 2 is responsible for identifying and investigating potential fraud, waste,… more
    State of Montana (12/17/25)
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