- Commonwealth Care Alliance (Boston, MA)
- …research, as necessary on all new and revised coding logic, related Medicare/ Medicaid policies for review/approval through the Payment Integrity governance ... health care reimbursement, public health care programs and reimbursement methodologies ( Medicaid and Medicare) Medical Coding, Compliance, Payment Integrity and… more
- CVS Health (Salem, OR)
- …May also load third party contracted reimbursement into applicable systems. Required Qualifications 1 -3 years' of Medicaid claims experience. 1 -3 years' ... (ie, directory listings). Develops and maintains standards for database integrity , corrective actions, database alignment, and manages communication processes with… 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...checks, and additional data review steps, to ensure data integrity of member record to include accurate ASAP, LTSC… more
- Oracle (Salem, OR)
- …arena. We are looking for a Senior Claims Denial Prevention and Appeals Specialist for providing clinical inputs to engineering for developing the Claim Denial ... 2-3 years of Utilization Review experience in a healthcare setting preferred; 1 -2 years of experience in hospital audits preferred Associate or bachelor's degree… more
- Trinity Health (Grove City, OH)
- …Full time Shift: Day Shift Description: Position Purpose: Patient Financial Specialist I; Ensures the collection of accurate and complete registration/admission ... ICD-9 coding to ensure compliance with third party regulations. Understands Medicare, Medicaid and other third party information requirements and adheres to all… more
- New York State Civil Service (New York, NY)
- NY HELP Yes Agency Medicaid Inspector General, NYS Office of the Title Medicaid Integrity Specialist 1 /Trainee 1 /Trainee 2 (NY HELPS) ... more of permanent or contingent-permanent competitive service, or 55 b/c service as a Medicaid Integrity Specialist 1 ; OR current New York State Employee… more
- New York State Civil Service (Hauppauge, NY)
- NY HELP Yes Agency Medicaid Inspector General, NYS Office of the Title Medicaid Integrity Specialist 1 /Trainee 1 /Trainee 2 Financial Analysis (NY ... 11788 Duties Description Duties include:Reporting directly to an audit supervisor, the Medicaid Integrity Specialist 1 (Financial Analysis) prepares and… more
- New York State Civil Service (Albany, NY)
- …year or more of permanent or contingent-permanent competitive service, or 55 b/c service as a Medicaid Integrity Specialist 1 ; OR current New York State ... NY HELP Yes Agency Medicaid Inspector General, NYS Office of the Title Administrative Specialist 1 /Trainee 1 /Trainee 2 (NY HELPS) Occupational Category… more
- Commonwealth Care Alliance (Boston, MA)
- …research, as necessary on all new and revised coding logic, related Medicare/ Medicaid policies for review/approval through the Payment Integrity governance ... the required certification OR willing to get certified within 1 year of employment - + Certified Professional Coder...Medicaid and Medicare) + Medical Coding, Compliance, Payment Integrity and Analytics + Direct and relevant experience with… more
- CVS Health (Helena, MT)
- …also load third party contracted reimbursement into applicable systems. **Required Qualifications** - 1 -3 years' of Medicaid claims experience. - 1 -3 years' ... (ie, directory listings). - Develops and maintains standards for database integrity , corrective actions, database alignment, and manages communication processes with… more
