- Corewell Health (Grand Rapids, MI)
- Job Summary Responsible for the analysis, research and completion of complex member appeal investigations. Effectively administer all steps of the member appeal ... hearing processes for all non-Medicare products to thoroughly investigate appeal requests, leveraging critical thinking skills, gathering relevant information from… more
- Point32Health (Watertown, MA)
- …on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around ... of all of our colleagues, which helps us to provide service with empathy and better understand and meet...Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst is responsible per State and Federal regulations for… more
- Louisiana Department of State Civil Service (LA)
- …family cases. Assesses financial resources to determine an absent parent's ability to provide support. Monitors all support payment activity on assigned cases ... SOCIAL SERVICES ANALYST 1/2/3 (LAFAYETTE REGION) Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4776267) Apply SOCIAL SERVICES ANALYST … more
- LogixHealth (Dania, FL)
- Location: On-Site in Dania, FL $500 Signing Bonus This Role: As a Reimbursement Analyst at LogixHealth, you will work with the department management teams to ... provide cutting edge solutions that will directly improve the...your expertise to review reimbursements and issues in Carrier Payment Audits. The ideal candidate will have strong technical… more
- Sysco (Houston, TX)
- …including real estate tax, personal property tax, valuation, audits, tax bill payment , budgeting, and forecasting. Internally collaborate and provide guidance ... annual business personal property and inventory returns.** **Support the tax bill payment process.** **Work with leadership to scope, propose, and execute value… more
- Commonwealth Care Alliance (Boston, MA)
- …regulations, and CMS payment methodologies (eg, DRG, APC, RBRVS). + Support provider appeal reviews and internal payment integrity investigations by ... as a subject matter expert on Medicaid (MassHealth), Medicare, and commercial payment methodologies and supports audit, compliance, and provider engagement… more
- Guthrie (Sayre, PA)
- …to secure appropriate payment . Trends corrections and works with Reimbursement and provider office staff to educate. 4. Uses payer submission log and Follow up ... thorough understanding of the requirements of the Government and Non‐Government payment policies & payer contracts. Trains Insurance Billing Specialists and related… more
- City and County of San Francisco (San Francisco, CA)
- …with federal and state regulations related to case service delivery, ensuring payment requests are accurate and services are appropriate. 2. Conduct field ... policies and procedures to ensure alignment with federal and state regulations; provide policy interpretation as needed. 9. Provide training, guidance, and… more
- The County of Los Angeles (Los Angeles, CA)
- …in Southern California, over 116,000 employees in more than 39 departments provide vital public services as diverse as law enforcement, property assessment, public ... and manage schedules and budgets. Familiar with processing change orders and payment requests. Works with County Counsel to review and resolve contractual issues… more
- Robert Half Finance & Accounting (Eatontown, NJ)
- …The Director will have advanced level of knowledge of government payment regulation, third party revenue accounting practices, and have excellent communication/staff ... and responds to audit reviews/questions/adjustments + Monitor Medicare and Medicaid appeal and cost report reopening issues. + Completed Medicare 855As (and… more
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