• Medicare / Medicaid Claims Editing…

    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 ... research, as necessary on all new and revised coding logic, related Medicare / Medicaid policies for review/approval through the Payment Integrity governance… more
    Commonwealth Care Alliance (11/25/25)
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  • Sr Medicare Medicaid Biller…

    Prime Healthcare (Redding, CA)
    …family. For more information, visit www.shastaregional.com. Responsibilities The Senior Medicare - Medicaid Biller/Collector is responsible for both billing and ... the specific payer guidelines, policies, procedures, and compliance regulations for Medicare - Medicaid . This includes maintaining the deficiency lists used to… more
    Prime Healthcare (12/30/25)
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  • Data Analyst/Statistician ( Medicare

    General Dynamics Information Technology (Fairfax, VA)
    …on a Data Analyst/Statistician joining our team to support the Centers for Medicare and Medicaid Services. You will support a diverse and multi-disciplinary ... focus on statistical methods + Five years of experience working with Medicare or Medicaid or private healthcare payer as a statistician or healthcare economist +… more
    General Dynamics Information Technology (01/07/26)
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  • Eligibility & Revenue Operations Representative-…

    Fallon Health (Worcester, MA)
    …strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid , and PACE (Program of All-Inclusive Care for the ... SLA's. With speed, accuracy, and integrity, ensures that enrollee data for Medicare Advantage, Medicare Supplement, NaviCare, Summit Elder Care, Fallon Health… more
    Fallon Health (11/18/25)
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  • Patient Account Representative - Medicare

    Guidehouse (El Segundo, CA)
    …from home._** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare / Medicaid + Insurance Follow-up + Customer Service + Billing + UB-04 & ... CMS 1500 + Complete all business-related requests and correspondence from patients and insurance companies. + Responsible for working on 40-70 Accounts Per Day + Complete all assigned projects in a timely manner. + Assist client and patients in all requested… more
    Guidehouse (12/12/25)
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  • VP Government Programs - Medicare & Managed…

    Prime Therapeutics (Frankfort, KY)
    …drives every decision we make. **Job Posting Title** VP Government Programs - Medicare & Managed Medicaid (REMOTE) **Job Description** The Vice President ... Government Programs - Medicare & Managed Medicaid is responsible for the development, administration, and execution of strategic plans that advance Prime's… more
    Prime Therapeutics (01/07/26)
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  • Senior Medicaid & Medicare

    OhioHealth (Columbus, OH)
    …**Job Description Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This ... position will be responsible for ensuring the appropriate governmental ( Medicare and Medicaid ) reimbursement is received for OhioHealth. * This position is… more
    OhioHealth (12/25/25)
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  • Medicare Part A Institutional Reimbursement…

    Centers for Medicare & Medicaid Services (Woodlawn, MD)
    Summary The Centers for Medicare and Medicaid Services (CMS) seeks candidates, including accountants and attorneys, to fill a vacant position on the Provider ... five-member panel that adjudicates disputes over institutional reimbursement matters in the Medicare program. Responsibilities Serves as a Member of the five Member… more
    Centers for Medicare & Medicaid Services (12/21/25)
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  • Financial Analyst Senior - Medicare

    Geisinger (Danville, PA)
    Job Summary We are seeking a detail-oriented professional with expertise in Medicare and Pennsylvania Medicaid cost reporting to join our team. The ideal ... candidate will have a strong understanding of Medicare settlement processes, compliance requirements, and hospital reimbursement regulations. This role requires the… more
    Geisinger (12/05/25)
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  • Physician

    Centers for Medicare & Medicaid Services (Woodlawn, MD)
    …This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare (CM). As a ... you will provide technical expertise concerning clinical aspects of the Medicare fee-for-service program and Medicare Shared Savings Program. Responsibilities… more
    Centers for Medicare & Medicaid Services (12/17/25)
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