• Claims ( Medicaid

    AmeriHealth Caritas (Robbinsville, NJ)
    …maximize efficiency, and integrate services. For more;information, visit www.performcare.org **Summary:** The Claims Eligibility Specialist is the point of ... internal associates and staff from various Provider agencies on Medicaid eligibility and claims issues....in coverage, eligibility , enrollment, and billing, the Claims Eligibility Specialist reviews, researches,… more
    AmeriHealth Caritas (01/03/25)
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  • Quality Assurance Specialist II (MD…

    CareFirst (Baltimore, MD)
    …and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** Medicare/ Medicaid Member Service **Equal ... **Resp & Qualifications** **PURPOSE:** The Quality Specialist II is responsible for examining and evaluating the accuracy of transactions in accordance with… more
    CareFirst (01/14/25)
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  • Claims Coding Specialist

    Whitney Young Health Center (Albany, NY)
    Claims Coding Specialist (Req 100825) Albany, NY (http://maps.google.com/maps?q=526+Central+Ave+Albany+NY+USA+12206) Apply Description GENERAL RESPONSIBILITIES: ... Responsible for reviewing medical claims prior to submission and following up on more...billing; Local Medical Review Policies (LMRP) for Medicare and Medicaid services; Medical terminology and abbreviations; Medicare and … more
    Whitney Young Health Center (11/09/24)
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  • Pharmacy Claims Specialist - Full…

    Hackensack Meridian Health (Eatontown, NJ)
    …Customer Pre-Admission Price Quotes. 11. Check Medicaid eligibility on Medicaid Pending LTC residents and rebill claims 12. Other duties as assigned. ... claims . **Responsibilities** A day in the life of a Pharmacy Claims Specialist at Hackensack Meridian _Health_ includes: 1. Submit daily prescription… more
    Hackensack Meridian Health (01/04/25)
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  • Operations and Medicaid Section Supervisor

    State of Montana (Helena, MT)
    …program benefit levels. Provides fiscal impact analysis based on utilization and claims data as appropriate for programmatic or legislative changes and updates. The ... and Budget Analyst on development, tracking and projecting the divisions Medicaid budget expenditures. The Operations Research Section Supervisor assists the… more
    State of Montana (12/24/24)
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  • Disabled Buy-In Claims Test Analyst

    State of Colorado (CO)
    …supports the various State and Federal audits of the MMIS and resulting Medicaid claims reimbursement, provider enrollment and medical benefit coverage. This ... Management Information System (MMIS), in order to assure timely and accurate Medicaid Disabled Buy-In Claims System processing and payments in an environment… more
    State of Colorado (01/18/25)
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  • Education Finance Specialist 1, Education…

    New York State Civil Service (Albany, NY)
    NY HELP Yes Agency Education Department, State Title Education Finance Specialist 1, Education Finance Specialist Trainee 1 (NY HELPS), Box CFO-735/60062 ... Albany Street Address Office of the Chief Financial Officer Medicaid Office City Albany State NY Zip Code 12234...Financial Officer is seeking candidates for an Education Finance Specialist 1 position in the System to Track and… more
    New York State Civil Service (01/11/25)
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  • Medical Billing Specialist III/IV

    Ventura County (Ventura, CA)
    Medical Billing Specialist III/IV Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4539404) Apply  Medical Billing Specialist III/IV Salary ... (III, IV), performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal,… more
    Ventura County (11/28/24)
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  • Insurance Specialist

    TEKsystems (Woods Cross, UT)
    …needed with healthcare organization, SLC - Utah Job Description As an Insurance Specialist , you will conduct insurance verification and eligibility for services, ... Medicare, Medicaid , and insurance regulations, assist with problem resolution on claims , billing, and eligibility issues with carriers, and answer incoming… more
    TEKsystems (01/15/25)
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  • Ambulance and Waiver Program Specialist 2

    State of Montana (Helena, MT)
    …Division seeks to provide health care for low-income and disabled Montanans through Medicaid , the Health and Economic Livelihood Partnership (HELP Aka Medicaid ... include working with the administrative rules, statutes, and policies concerning the claims payment system and coding; working with members and providers concerning… more
    State of Montana (11/27/24)
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  • Medical Biller/Collections Specialist

    Robert Half Accountemps (Minnetonka, MN)
    …patient accounts to identify and resolve any discrepancies * Keep up-to-date with Medicaid eligibility requirements to ensure accurate billing * Perform benefit ... using Allscripts and Cerner Technologies * Handle Medicare and Medicaid billing, ensuring all claims are accurate...in processing Medicaid Claim * Understanding of Medicaid Eligibility * Familiarity with Medicare processes… more
    Robert Half Accountemps (01/23/25)
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  • Clinical Denials Coding Review Specialist

    HCA Healthcare (Nashville, TN)
    …provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility , for external clients across the country. Parallon has ... to join an organization that invests in you as a Clinical Denials Coding Review Specialist ? At Work from Home, you come first. HCA Healthcare has committed up to… more
    HCA Healthcare (01/18/25)
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  • Remote Billing Specialist - Healthcare

    TEKsystems (Colorado Springs, CO)
    …and internal policies and procedures. + Ensure timely and accurate billing of claims via electronic or paper to Medicare, Medicaid , and Commercial Insurances ... Medical Device company based out of California is interested in hiring a Billing Specialist in a fully remote opportunity. The team is interested in candidates with… more
    TEKsystems (01/19/25)
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  • Sr Appeals Specialist

    Medical Mutual of Ohio (Brooklyn, OH)
    …systems, determines eligibility , benefits, and prior activity related to the claims payment or service denial issues related to appeal requests. Completes cases ... Specialist or equivalent experience in Medicare health insurance claims , customer service, billing or related operations preferred. **Professional… more
    Medical Mutual of Ohio (11/14/24)
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  • Health System Specialist (Provider…

    Indian Health Service (Whiteriver, AZ)
    …is responsible for completing revalidation and re-enrollment requests from CMS, Arizona Medicaid , and other state Medicaid programs as required. This position ... provider authorized organization official to review and complete CMS, state Medicaid , private insurance, and managed care applications. Submits with administrative… more
    Indian Health Service (01/16/25)
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  • Specialist , Appeals & Grievances

    Molina Healthcare (Columbus, OH)
    …of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge ... and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution… more
    Molina Healthcare (01/21/25)
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  • Medical Billing Specialist

    TEKsystems (Phoenix, AZ)
    …and internal policies and procedures. + Ensure timely and accurate billing of claims via electronic or paper to Medicare, Medicaid , and Commercial Insurances ... Description - **DME BILLING/ CLAIMS EXPERIENCE REQUIRED** Primary responsibilities will include submitting...Skills & Qualifications * A comprehensive understanding of Medicare, Medicaid , and/or Commercial Insurance program rules as it pertains… more
    TEKsystems (01/18/25)
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  • Billing Specialist

    TEKsystems (Raleigh, NC)
    …and internal policies and procedures. * Ensure timely and accurate billing of claims via electronic or paper to Medicare, Medicaid , and Commercial Insurances ... Description Primary responsibilities will include submitting claims , posting payments, working payor rejections and denials, and completing follow ups to ensure… more
    TEKsystems (01/18/25)
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  • Patient Access Specialist 1

    Trinity Health (Chelsea, MI)
    …for the purpose of establishing the patient and service specific record for claims processing and maintenance of an accurate electronic medical record. Registers and ... information system(s), to ensure accurate and timely submission of claims . Determines visit-specific co-payments and collects out-of-pocket liabilities. Assists… more
    Trinity Health (01/21/25)
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  • Medical Billing Specialist

    Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
    **39868BR** **Extended Job Title:** Medical Billing Specialist **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** Responsible for ... ensuring accurate billing for timely submission of claims , monitoring claim status, investigating claim denials/rejections, and documenting related account… more
    Texas Tech University Health Sciences Center - El Paso (01/10/25)
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