- Christus Health (Albuquerque, NM)
- …making an application. POSITION SUMMARY: Responsible for performing billing, collections and reimbursement services of claims and duties of the hospital business ... EXPERIENCE: Two years of experience preferred in any of the following: Medicare , Medicaid and/or Commercial Insurance billing, collections, payment and … more
- Lyric (Newtown Square, PA)
- …understanding of US health insurance payers including Commercial, Medicare , Medicaid (FFS and MCOs), third-party claims processing (including paper & ... subject matter expert on CPT, HCPCS, ICD10CM coding and claims edit logic (including NCCI, LCDs, State Medicaid...of experience in a health insurance payer or automated claims editing solution, as a payment, reimbursement … more
- Stony Brook University (East Setauket, NY)
- …+ Experience with Inpatient and Outpatient billing requirements (UB-04/837i) and/or CMS Medicare and New York Medicaid reimbursement methodologies. + ... support day-to-day business functions including but not limited to: billing, claims analysis appeals, follow-up, financial assistance and customer service. **Duties… more
- Commonwealth Care Alliance (Boston, MA)
- …initiatives to achieve high performance on CCA's Population Health goals; including Medicare Star measures, Medicaid - Medicare Plan withhold measures, quality ... CAHPS, HOS) and value-based contract performance metrics + Experience with Medicare Advantage, Medicaid ; and dually eligible populations **Desired Experience**… more
- Commonwealth Care Alliance (Boston, MA)
- …Required Knowledge, Skills & Abilities (must have): - Strong understanding of claims processing, reimbursement methodologies, and payment policies, with the ... their impact on provider operations and satisfaction. - Strong understanding of Medicare and Medicaid health plan operations, including regulatory and compliance… more
- Stony Brook University (East Setauket, NY)
- …variances and denials. + Expert knowledge of Medicare and NY Medicaid Inpatient and Outpatient reimbursement methodologies. + Expert knowledge of third ... limited to:** + Develops staff work listing logic/strategy and claims resolution work flows. + Educates and trains new...+ Assists in maintaining and creating payer report cards, claims tracking and management reporting as requested. + Assists… more
- Commonwealth Care Alliance (Boston, MA)
- …experience + Experience in health plan provider relations. **Experience (Desired)** + Medicare / Medicaid experience preferred. + Experience with CPT coding and ... with key providers; orient providers on CCA's policies related to: Claims and service recovery; Program benefits; Clinical initiatives; Referral and authorization;… more
- Commonwealth Care Alliance (Boston, MA)
- …Mentoring subject matter expert of the team + Managed Care experience (preferably Medicare / Medicaid ) + Experience in health plan provider relations + Experience ... + **Operational Excellence:** + Collaborate with cross-functional teams (eg, Claims , Credentialing, Clinical Care Management, Member Services, Provider Services,… more
- Moses/Weitzman Health System (Middletown, CT)
- …ICD-10 Codes, Medicare and Medicaid billing rules. Insurance reimbursement methods, the claims appeal process, understanding of managed care contracts ... and performs all aspects of accounts receivable collection and reprocessing of claims . **ROLE AND RESPONSIBILITIES** + Audits and resolves accounts with credit… more
- 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
