- Prime Therapeutics (Columbus, OH)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Senior Medicare Claims Specialist - Remote **Job Description** The Claims ... member satisfaction + Serve as the escalation point for Claims Specialist ; provide guidance and mentoring to...RxCLAIM + Experience in PBM industry + Experience with Medicare Part D + Experience using Microsoft Office products,… more
- Guidehouse (Lewisville, TX)
- …**Clearance Required** **:** None **What You Will Do** **:** The **Team Lead - Medicare Specialist ** will assist in overseeing the daily operations of assigned ... Chris Rivera (Manager, Talent Acquisition) at ###_** + **Strong Medicare emphasis** + Assisting team members both onshore and...**What Would Be Nice To Have** **:** + Strong Medicare background + Demonstrated proficiency in relevant revenue cycle… more
- Martin's Point Health Care (Portland, ME)
- …certified as a "Great Place to Work" since 2015. Position Summary Job Description Medicare Part D Specialist is responsible for coordinating and performing ... D programs, this position also coordinates member-centered activities related to the Medicare pharmacy and Stars programs. This position works with internal and… more
- Centers for Medicare & Medicaid Services (Woodlawn, MD)
- …implementation of policies related to claims processing and system work. Perform Medicare claims processing, claims reviews, and the adjudication of ... (CMMI), Business Services Group (BSG). As a Health Insurance Specialist ( Claims Processing & Systems), GS-0107-13, you... claims to administer and monitor contracts with Medicare contractors. Review and provide analysis for claims… more
- Aveanna (Atlanta, GA)
- Workers Compensation Claims Specialist ApplyRefer a FriendBack Job Details Requisition #: 195090 Location: Atlanta, GA 30339 Category: Compliance Salary: $45,000 ... - $55,000 per year Position Details Position Overview The Workers Compensation Claims Specialist is responsible for the being the liaison between the Aveanna… more
- Houston Methodist (Katy, TX)
- Medicare compliance experience is preferred** **Note: Office for this position is located at our Continuing Care Hospital:** **701 S. Fry Rd. Katy, TX 77450** **. ... (Hybrid position)** At Houston Methodist, the CBO Regulatory Compliance Specialist position is responsible for working with Houston Methodist's Corporate Central… more
- Community Clinic Inc. (Silver Spring, MD)
- …a more equitable health care system for everyone. Position Summary CCI is seeking a Claims Specialist to serve as a financial resource in support of the clinical ... services provided. The Claims Specialist will assure that services are.... + Maintain current understanding and application of all Medicare and state Medicaid compliance requirements regarding avoidance of… more
- PruittHealth (Norcross, GA)
- …all Insurance billing services by final/higher level auditing, correcting, and submitting claims . Ensures that billing services are timely, accurate, and allow for ... appropriate reimbursement. Conducts all claims -related follow up on payment delays, taking corrective action(s) to finalize account disposition and/or referring … more
- BrightSpring Health Services (Uniondale, NY)
- …billing to eliminate financial risks + Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D plans, third party ... retail to office environment for those who are willing to learn claims , billing and insurance processing. Pharmacy Technician experience and/or knowledge of… more
- National Health Care Associates (Marlborough, CT)
- …triple check to review + Correct all skilled/Part B payers as needed + Coordinate with Medicare Specialist when claims are ready for Core Submission for ... Medicare A/B. + Monthly review of Medicare Common Working File for all Rehab B patients...patients for changes/updates + Track and review all managed claims for follow up through payment + Post managed… more
- LA Care Health Plan (Los Angeles, CA)
- Claims Documentation Specialist II Job Category: Claims Department: Claims Data and Support Services Location: Los Angeles, CA, US, 90017 Position Type: ... to support the safety net required to achieve that purpose. Job Summary The Claims Documentation Specialist II is responsible for creating, editing and updating… more
- Kelly Services (Mason, OH)
- …. We at Kelly(R) hear you, and we're here for you! We're seeking a ** Claims Specialist ** to work at a leading designer, manufacturer, and distributor of fashion, ... 9000 ksmp or higher. + Experience or knowledge in Medicare /Medicaid regulations is highly preferred. + Availability to work...so let's get to work. Apply to be a ** Claims Specialist ** today! As part of our… more
- Modernizing Medicine (Boca Raton, FL)
- …across the US. ModMed (https://www.modmed.com/company/) is hiring a driven Patient Claim Specialist who will play a pivotal role in shaping a positive patient ... all inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections + Initiate outbound calls… more
- Trinity Health (Farmington Hills, MI)
- …draws conclusions, and reviews findings with all levels of Payment Resolution Specialist for further review. Serve as a resource to Payment Resolution Specialists ... insurance and governmental programs, regulations and billing processes (eg, Medicare , Medicaid, Social Security Disability, Champus, Supplemental Security Income… more
- Ventura County (Ventura, CA)
- …for Medi-Cal and/or Medicare and prepares reports; + Serves as lead biller/ specialist to the department; and + Performs other related duties as required. Medical ... processing claims for timely reimbursement and compliance with Medi-Cal, Medicare , and general insurance requirements. Please include the following in your… more
- Montrose Memorial Hospital (Montrose, CO)
- …+ The Claims Analyst III must know the essential functions of denied claims for Medicare , Medicaid and Commercial payers for accurate payments of services ... Association of Hospital Administrative Management) CRCS (Certified Revenue Cycle Specialist ) preferred. + 2 years hospital PFS department experience with… more
- Medical Mutual of Ohio (OH)
- …Medicare Supplement, and individual plans. **Responsibilities** **Business Systems Specialist I** Works with management, external vendors, and Information Systems ... impacts for business requirements. Drives change by creating viable solutions to Claims and Customer Care. . Works independently with Information System Development… more
- Martin's Point Health Care (Portland, ME)
- …and education + 5+ years experience in managed care plan required; knowledge of Medicare Advantage (for Medicare Specialist ) or TRICARE (for USFHP ... to Work" since 2015. Position Summary Job Description Position Summary: The Appeals Specialist ( Medicare or US Family Health Plan) is responsible for ensuring… more
- Medical Mutual of Ohio (OH)
- …insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Prepares invoices for ... work remotely in the state of Ohio._** **Responsibilities** **Client Accounting Specialist I** + **Conducts weekly and monthly invoicing of self-administered groups-… more
- Robert Half Finance & Accounting (Hunt Valley, MD)
- …Medicaid Eligibility is crucial * Prior experience in working with Medicare , Medicare Billing, and handling Medicare Claims is highly beneficial * ... Description We are looking for a dedicated Medical Accounts Receivable Specialist to become a part of our healthcare team based in Hunt Valley, Maryland. This is a… more