- Bear Mountain Health Care (MA)
- …Home Medicaid EXPERT? Bear Mountain Healthcare is currently seeking a full time Medicaid Pending Specialist to assist in the completion of Medicaid ... facilities in Massachusetts. Duties include: . Responsible for working Pending Medicaid applications and re-determinations in order to ensure financial eligibility.… more
- Commonwealth Care Alliance (Boston, MA)
- …that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for timely review and ... as necessary on all new and revised coding logic, related Medicare/ Medicaid policies for review/approval through the Payment Integrity governance process.… more
- Commonwealth Care Alliance (Boston, MA)
- …The Claims Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare, and commercial payment methodologies and supports audit, compliance, and ... - AAPC + Certified Claims Professional (CCP) + Other AHIMA or Medicaid billing-related certifications **Required Experience (must have):** + 3+ years in healthcare… more
- Sumitomo Pharma (Boston, MA)
- …highly motivated individual for the position of **Multi-Specialty Portfolio Specialist .** In this field-based role, the **Multi-Specialty Portfolio Specialist ... tactical, energetic and thrive in a nimble organization. The **Multi-Specialty Portfolio Specialist ** will demonstrate a sense of urgency to prepare and successfully… more
- Commonwealth Care Alliance (Boston, MA)
- …appropriateness, efficiency and quality of the services provided. The LTSS Program Specialist will have a wide range of responsibilities including project management ... and (e)assistance to these external partners as necessary. The Specialist is expected to work with managers and staff...that CCA implements. * Working knowledge of Medicare and Medicaid (MassHealth) * Familiarity with and full support of… more
- Commonwealth Care Alliance (Boston, MA)
- …Network Strategic Initiatives & Data Management, the Provider Data Outreach Specialist is responsible for executing outbound call campaigns to healthcare providers ... Familiarity with medical terminology, preferred. * Previous experience Medicare and Medicaid strongly preferred Required Knowledge, Skills & Abilities (must have): *… more
- Prime Therapeutics (Boston, MA)
- …every decision we make. **Job Posting Title** Medication Therapy Management Specialist **Job Description** The Medication Therapy Management (MTM) Service ... Specialist is responsible for receiving inbound and making outbound...targeted population; for Medicare, is Centers for Medicare & Medicaid Services (CMS) compliance compliant + Utilize Prime's MTM… more
- Fenway Health (Boston, MA)
- Behavioral Health Substance Use Disorder Specialist Boston, MA (http://maps.google.com/maps?q=1340+Boylston+St+Boston+MA+USA+02215) * Behavioral Health Job Type ... of the Manager of Integrated Behavioral Health Services, the Behavioral Health Specialist with specialty in evaluating and treating substance use disorder (SUD)… more
- Beth Israel Lahey Health (Westwood, MA)
- …over 25 affiliated health plans/ products, including Medicare and Medicaid . **Job Description:** **Primary Responsibilities:** **Facilitates timely enrollment of new ... and health plan enrollment and credentialing guidelines (including Medicare and Medicaid ). (essential)** **Compiles accurate health plan application packets for the… more
- Tufts Medicine (Lawrence, MA)
- …8. Completes, files, and follows to resolution applications for Massachusetts Medicaid , including disability, Health Safety Net, and other such programs. 9. ... Refers patients to programs where Hospital staff cannot file directly for the patient, including Veteran's Services, and EAEDC. 10. Works closely with and communicates consistently with Social Work, Case Management, Billing, and Contracting to provide a… more