• Medicare Community Engagement Spc. (Cook…

    Molina Healthcare (Worth, IL)
    …the product choices available to them, the enrollment process (eligibility requirements, Medicare review /approval of their enrollment application, timing of ID ... **Molina Healthcare** is hiring for a ** Medicare Community Engagement Specialist** in the **Cook County/Chicagoland** area. This role is field-based, candidates can… more
    Molina Healthcare (05/07/25)
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  • Account Rep, Medicare

    Molina Healthcare (Norfolk, MA)
    …the product choices available to them, the enrollment process (eligibility requirements, Medicare review /approval of their enrollment application, timing of ID ... for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare -Medicaid recipients within approved… more
    Molina Healthcare (04/30/25)
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  • Follow Up Associate, Medicare HMO

    R1 RCM (Chicago, IL)
    …in writing. **Here's what you will experience working as a Follow Up Associate, Medicare Advantage:** + Review account details, decide on the next best action, ... AI, intelligent automation, and workflow orchestration. As our **Follow Up Associate, Medicare Advantage,** you will help --improve revenue cycle outcomes for our… more
    R1 RCM (05/20/25)
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  • Medicare Biller / Accounts Receivable

    CommuniCare Health Services Corporate (Indianapolis, IN)
    …check forms and audit for accuracy per triple check policy prior to claims submission + Review of Medicare A, Medicare A No Pays/Benefit Exhaust, Medicare ... Medicare Biller The CommuniCare Family of Companies currently...living communities. CommuniCare Health Services is currently recruiting a Medicare Biller for our Central Billing Office in Cincinnati,… more
    CommuniCare Health Services Corporate (05/19/25)
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  • Non-Clinical Coding and OASIS Review

    BAYADA Home Health Care (Orlando, FL)
    …while using the Medicare PDGM billing model and CMS guidelines. + Review and communicate OASIS edit recommendations to each clinician to promote OASIS accuracy. ... Home Health Care is hiring a full time OASIS Review and Coding Manager. The OASIS and Coding ...review . + Knowledge of OASIS, Home Care and Medicare regulations + Excellent organizational, interpersonal and communication skills… more
    BAYADA Home Health Care (05/17/25)
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  • Patient Account Representative - Medicare

    Guidehouse (Lewisville, TX)
    …Antonio, TX offices and three days 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… more
    Guidehouse (03/16/25)
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  • Senior Manager, Actuarial

    Healthfirst (NY)
    …of business + Provide support for annual Medicare bids for all Healthfirst's Medicare products + Review and quantify any regulatory / CMS proposals and/or ... or any related degree + Experience in the actuarial field related to Medicare (bid development/ review , analysis, reporting, risk scores) + Ability to collect,… more
    Healthfirst (05/20/25)
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  • Registration Specialist Glendale Heights - PRN

    AdventHealth (Glendale Heights, IL)
    …insured and, if so, gathers details (eg, insurer name, plan subscriber) + Performs Medicare compliance review on all applicable Medicare accounts in order ... patients + Verifies medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards and communicates relevant coverage/eligibility… more
    AdventHealth (04/18/25)
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  • Clinical Review Nurse

    Hackensack Meridian Health (Eatontown, NJ)
    …for coding, OASIS and Hospice, and other clinical assessment tools as needed. + Review every Medicare and Managed Medicare admission chart to determine ... in the system if inappropriate codes are identified. + Review each Hospice assessment to assure each CTI, 485...in collecting information for accurate and timely coding. + Review HIS to assure an accurate reflection of the… more
    Hackensack Meridian Health (05/03/25)
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  • Clm Resltion Rep III, Hosp/Prv

    University of Rochester (Rochester, NY)
    …audits, and third-party payor audits + Coordinate responses and resolution to Medicaid and Medicare credit balances + Review all accounts on the Medicaid and ... Microsoft Word, Excel, Access, Email, Emdeon (Fidelis Medicaid Managed Care and Medicare Part B) clearinghouse software, third party claims systems (ePaces, Omnipro)… more
    University of Rochester (05/15/25)
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