- Commonwealth Care Alliance (Boston, MA)
- … Claims Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare , and commercial payment methodologies and supports audit, compliance, ... + Certified Professional Coder (CPC) - AAPC + Certified Claims Professional (CCP) + Other AHIMA or Medicaid...to have):** + Prior experience working with MassHealth and Medicare Advantage reimbursement rules is strongly preferred.… more
- Commonwealth Care Alliance (Boston, MA)
- …and medical coding (CPT, HCPCS, Modifiers) along with the application of Medicare /Massachusetts Medicaid claims ' processing policies, coding principals and ... Coding Sr. Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement ...new CPT and HCPCS codes for coding logic, related Medicare / Medicaid policies to make recommend reimbursement… more
- Guidehouse (Lewisville, TX)
- …from home._** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare / Medicaid + Insurance Follow-up + Customer Service + Billing + UB-04 & ... Flexible Spending Accounts + Short-Term & Long-Term Disability + Tuition Reimbursement , Personal Development & Learning Opportunities + Skills Development &… more
- Prime Healthcare (Ontario, CA)
- …seeking new members to join our corporate team! Responsibilities The Senior Medicare - Medicaid Biller/Collector is responsible for both billing and collections, ... the specific payer guidelines, policies, procedures, and compliance regulations for Medicare - Medicaid . This includes maintaining the deficiency lists used to… more
- 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
- Zelis (Plano, TX)
- …business administration, or a related field + Five+ years of experience in Medicaid billing, reimbursement , claim payment or cost reporting. + Experience with ... that shape who you are. Position Overview The Sr. Medicaid Regulatory Pricer Analyst will collaborate with the Zelis... Medicare / Medicare Advantage or commercial billing and reimbursement … more
- Staffing Solutions Organization (Albany, NY)
- …eligibility and claims systems. + Take the appropriate actions regarding Medicaid enrollment and premium reimbursement . + Demonstrate systems processes for ... may be received from a variety of sources such as Centers for Medicare and Medicaid Services (CMS), Insurance Carriers, and others. + Ability to problem solve… more
- Molina Healthcare (Milwaukee, WI)
- …their financial and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **JOB ... and manage information from large data sources. + Analyze claims and other data sources to identify early signs...- 5 years supervisory experience + Demonstrated understanding of Medicaid and Medicare programs or other healthcare… more
- Humana (Annapolis, MD)
- …days/week. **Required Qualifications** + Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with ... continuously improving consumer experiences **Preferred Qualifications** + Proven knowledge in Medicare and Medicaid regulations + Certifications (BA, MBA, JD,… more
- RWJBarnabas Health (Oceanport, NJ)
- …indicators associated with disease processes and pharmacology is required. + Knowledge of Medicare and Medicaid billing and coding regulations. + Must have ... Inpatient Coding Quality Officer III - ( Medicare ) RemoteReq #:0000183242 Category:Coder Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services… more