- Ventura County (Ventura, CA)
- …reimbursement for Medi-Cal and/or Medicare and prepares reports; + Serves as lead biller/ specialist to the department; and + Performs other related duties as ... processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare , and general insurance...Claim Source to follow up on accounts. Medical Billing Specialist IV is the lead level class… more
- Johns Hopkins University (Baltimore, MD)
- …manual or job aides for routine and special training programs. + Serves as Lead for compliance training and prepares and/or reviews all billing compliance ... by ensuring compliance with government regulatory guidelines (ie Centers for Medicare & Medicaid Services- CMS conditions of payment) and CPT coding standards. +… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Compliance Audit Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 ... achieve that purpose. Job Summary The Customer Solution Center (CSC) Audit Readiness Specialist II is responsible for the execution, oversight, and monitoring of the… more
- Molina Healthcare (South Florida, FL)
- …Quality Interventions and Quality Improvement Compliance . + Acts as a lead specialist to provide project-, program-, and / or initiative-related direction ... metrics/Risk Adjustment will receive first consideration.** **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist , Quality Interventions / QI Compliance contributes… more
- Northwell Health (Valley Stream, NY)
- …organization of assessment for patients/residents to comply with Centers for Medicare and Medicaid Services (CMS) and Department of Health requirements; assessing ... residents for Medicare and managed care benefits; ensuring continuous maintenance of...maximize reimbursement. + Carries out routine correspondence. + Ensures compliance to organization policies and procedures, and regulatory requirements.… more
- University of Washington (Seattle, WA)
- …) **This posting may be used to recruit for several Clinical Research Billing Specialist positions.** As a UW employee, you have a unique opportunity to change lives ... **The School of Medicine has an outstanding opportunity for a Clinical Research Billing Specialist to join their team.** UW Medicine works to improve the health of… more
- HonorHealth (Phoenix, AZ)
- …of the study. The position's competencies include operations, coding/billing compliance , Medicare coverage analysis/budgeting, contracting, Clinical Trial ... finance and accounting principles. The successful Associate Clinical Trials Operations Specialist will support business activities of the Honor Health Research… more
- Trinity Health (Sioux City, IA)
- …patient safety, and minimizes liability exposure. The specialist role is a lead resource in the Centers for Medicare and Medicaid Services (CMS) regulatory ... Purpose** The purpose of the Accreditation and Risk Management Specialist is to facilitate regulatory and risk management activities,...that ensures compliance , enhances… more
- Trinity Health (Troy, NY)
- …Notification Verification and Authorization (NoVA), Point of Service Cash Collection, Medicare Compliance , and Customer Service, across numerous state and ... pertaining to the healthcare industry. Ability to read, analyze, and interpret Medicare Compliance Regulations. + Working knowledge of third-party payer… more
- CAI (Columbus, OH)
- …Full time **Worksite Flexibility** Remote **Job Summary** As the HHS Solutions Specialist , you will to develop proposal responses and create tailored solutions for ... complex RFP requests in the Medicaid, Medicare , Child Welfare, and/or Child Support areas. **Job Description**...**Job Profile Summary** We are seeking a HHS Solutions Specialist to develop proposal responses and create tailored solutions… more
- Trinity Health (Westerville, OH)
- …relation between diagnosis and procedure using CPT and ICD-9 coding to ensure compliance with third party regulations. Understands Medicare , Medicaid and other ... **Employment Type:** Part time **Shift:** **Description:** Patient Financial Specialist I ensure the complete and accurate registration of patients in the Emergency… more
- Trinity Health (Westerville, OH)
- …relation between diagnosis and procedure using CPT and ICD-9 coding to ensure compliance with third party regulations. Understands Medicare , Medicaid and other ... **Employment Type:** Full time **Shift:** **Description:** Patient Financial Specialist I ensure the complete and accurate registration of patients in the Emergency… more
- MyFlorida (Marianna, FL)
- NURSING PROGRAM SPECIALIST - 67043639 - SUNLAND Date: Sep 13, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... Agency for Persons with Disabilities Working Title: NURSING PROGRAM SPECIALIST - 67043639 - SUNLAND Pay Plan: Career Service...the qualities of being humble, hungry, and smart and lead others to embody the same. This entails lacking… more
- Elevance Health (Vero Beach, FL)
- **Outreach Care Specialist - Florida** **Location** : This is a **field-based** position (50% - 75% of the time). Seeking candidates that reside in the state of ... 8am - 7pm EST and weekend availability as needed. Seeking an Outreach Care Specialist in Florida with expertise in healthcare, home health, Medicare , and mental… more
- HCA Healthcare (St. Petersburg, FL)
- …reference for team members + Research Patient Visit History to ensure compliance with Medicare rules, verify insurance information Qualifications for insurance ... organization that invests in you as a(an) Medical Office Specialist ? At HCA Florida Heart Institute, you come first....experts in hospitalist integration, and graduate medical education. We lead more than 1,300 physician practices and 170+ urgent… more
- Sumitomo Pharma (Fresno, CA)
- …motivated, and experienced individual for the position of **MSPEC** Portfolio Specialist . The successful candidate will be responsible for compliantly driving ... pharmaceutical environment. **Key Core Competencies** + Significant customer (PCP and specialist ) knowledge and understand the business channels and the business… more
- Sevita (Ann Arbor, MI)
- …codes, UB-04, and HCFA-1500 forms + Strong understanding of medical collections compliance , Medicare , Medicaid, Medicaid managed care, Commercial, Workers Comp, ... the United States. Our extraordinary team offers innovative, quality services and support that lead to growth and new opportunities for the people we serve and for… more
- Trinity Health (Livonia, MI)
- …secondary diagnoses, principal procedure and secondary procedures. Assigns appropriate Medicare Severity Diagnosis Related Groups (MS-DRG), All Patient Refined DRGs ... ICD-CM Official Coding Guidelines for Coding and Reporting, Centers for Medicare /Medicaid Services (CMS) ICD-PCS Official Guidelines for Coding and Reporting *… more
- UTMB Health (Webster, TX)
- …Obtains and documents information required for third party reimbursement. . Ensures compliance with Medicare and third-party coverage. . Communicates with ... Patient Services Specialist II - Access Center **Webster, Texas, United...services for new and returning patients. **ESSENTIAL JOB FUNCTIONS:** ** Lead Responsibilities** . Ability to function as a team… more
- Spaulding Rehabilitation (Charlestown, MA)
- …overall quality, completeness, and accuracy of medical record documentation to ensure compliance with Medicare and Medicaid (CMS) regulations and guidelines and ... Clinical Documentation Integrity Specialist , Per Diem - ( 3303241 ) **Description**...extensive interaction with physicians, nurses, other patient caregivers, and Compliance , Coding, and Outcomes staff. Educates members of the… more