- Teva Pharmaceuticals (Parsippany, NJ)
- Medicaid Claims Analyst Date: Oct 21, 2024 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 57268 **Who we are** Teva ... healthier lives. Join us on our journey of growth! **The opportunity** The Medicaid Claims Analyst is responsible for Medicaid Drug Rebate process which… more
- Select Medical (Canonsburg, PA)
- **Overview** **Patient Account Representative (Managed Care Medicaid Claims )** **- Join Our Team at Select Medical!** **Starting Pay:** $16.50 per Hour (DOE) ... team! **Responsibilities** + Investigate and follow-up on all open Managed Care Medicaid Claims account balances overdue for 45 days or more to determine reason… more
- Providence (OR)
- …time **Job Shift:** Day **Career Track:** Admin Support **Department:** 5018 OPS PHT CLAIMS MEDICAID OR REGION **Address:** OR Salem 3993 Fairview Industrial Dr ... **Description** Providence Health Plan is calling an Associate Claims Specialist, Medicaid who will process claims for members, providers, and employers.… more
- Guidehouse (Lewisville, TX)
- …at ###_** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare/ Medicaid + Insurance Follow-up + Customer Service + Billing + UB-04 & CMS 1500 ... + Complete all business-related requests and correspondence from patients and insurance companies. + Responsible for working on 40-70 Accounts Per Day + Complete all assigned projects in a timely manner. + Assist client and patients in all requested tasks. +… more
- Sumitomo Pharma (Columbus, OH)
- …resolve disputes and to clean up historical utilization that is routinely submitted with Medicaid claims . In addition, the analyst will load Medicaid claim ... highly motivated, and experienced individual for the position of **Analyst, Medicaid Rebates.** This individual contributor role is responsible for processing … more
- New York State Civil Service (New York, NY)
- …clinic owner for defrauding New York State out of more than $4 Million in false Medicaid claims ; and the extradition, arrest, and arraignment of a Medicaid ... Attorney General, Office of the Title Legal Support Analyst: Support Medicaid Fraud Investigations (6348) Occupational Category Legal Salary Grade NS Bargaining… more
- MyFlorida (West Palm Beach, FL)
- …litigation matters and analytical projects. + Create customized downloads from on-line Medicaid claims data warehouse as requested by investigators, attorneys, ... MEDICAID FRAUD ANALYST II - 41001054 Date: Oct...840413 Agency: Office of the Attorney General Working Title: MEDICAID FRAUD ANALYST II - 41001054 Pay Plan: Career… more
- New York State Civil Service (New York, NY)
- …for defrauding New York state out of more than $4 Million in false Medicaid claims .Duties: * Assisting with screening and evaluating complaints of abuse and ... Attorney General, Office of the Title Legal Nurse: Medical Analyst Support Medicaid Fraud Cases (6345) Occupational Category Legal Salary Grade NS Bargaining Unit… more
- PruittHealth (Norcross, GA)
- …**ESSENTIAL JOB FUNCTIONS, DUTIES, AND RESPONSIBILITIES:** * Prepare and transmit Georgia Medicaid claims . * Research, correct and re-bill outstanding ... Medicaid claims . * Responsible for Medicaid Collections and Days Sales Outstanding. * Work with the healthcare center administrator and office personnel to… more
- Commonwealth Care Alliance (Boston, MA)
- …coding (CPT, HCPCS, Modifiers) along with the application of Medicare/Massachusetts Medicaid claims ' processing policies, coding principals and payment ... the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr....Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding reviews for claims ,… more
- Idaho Division of Human Resources (Boise, ID)
- …or medical auditing. Must have the ability to analyze, interpret, and summarize Medicaid claims data, business records, financial records and medical records. ... Medicaid Fraud Control Unit Investigative Auditor , OAG...Auditor position will be assigned to the Attorney General's Medicaid Fraud Control Unit (MFCU). The federally funded and… more
- Staffing Solutions Organization (Albany, NY)
- …understanding of database structures and business context of various elements related to Medicaid claims . Related efforts will include the production of reports ... Medicaid Program Advisor One Commerce Plaza, Albany, 99...reflection of our clients and the people they serve. ** Medicaid Program Advisor, Albany NY** **DDSA - 1140** **Summary**… more
- Insight Global (Hartford, CT)
- …background in the Medicaid or healthcare domain with experience in the claims provider area. This person should have experience working in a matrixed environment ... 7+ years of experience as an IT Business Analyst Domain experience within Medicaid or healthcare claims provider Strong expertise gathering and writing business… more
- TEKsystems (Montgomery, AL)
- …* Demonstrate data literacy and be resourceful in terms of understanding Medicaid Eligibility, Claims Processing, Federal reporting, Quality measures, Gap ... healthcare payer data analysis experience with one or more of the following: Medicaid data, Medicare data, Healthcare Exchange data or Commercial payer data *… more
- Rochester City School District (Rochester, NY)
- …regulations, and laws;Reviews documentation of service deliveries to support claims for Medicaid reimbursements;Reviews quarterly progress reports, assessments, ... and training for the district's outside agencies;Maintains supporting documentation for all claims submitted for Medicaid reimbursement in compliance with all… more
- Conduent (Helena, MT)
- …of a culture where individuality is noticed and valued every day. ** Claims Transactions Processor** **Monday - Friday 8:00am - 5:00pm** **$16.75/hr** **Principal ... diploma or equivalent. **_Preferred Qualifications and Success Factors:_** + Medical claims and payment processing experience preferred + Accurate typing skills +… more
- Phoebe Ministries (Allentown, PA)
- …monthly claims and any claim adjustments that may be required based on Medicaid protocols to adjudicate claims . The Medicaid analyst will review, ... responsible for the submission of all 180-day exception unit claims . Payments associated with Medicaid will require accurate posting to Resident accounts and the… more
- Molina Healthcare (NM)
- **JOB DESCRIPTION** **Job Summary** Responsible for reviewing Medicaid , Medicare, and Marketplace claims for overpayments; researching claim payment guidelines, ... overpayment notification and supporting documentation such as explanation of benefits, claims and attachments. + Maintains and reconciles department reports for… more
- TEKsystems (Los Angeles, CA)
- …, facility claims , commercial claims , Medicare claims , managed Medicare claims &/or Medicaid claims ) * Both Cerner, EPIC & Follow-up experience. ... insurance billing, insurance follow up, appeals, medical record, open enrollment, claims resolution, denied claims , medicaid , medical collections,… more
- Humana (Frankfort, KY)
- …of CAS claims experience + 2 years or more experience with Medicare/ Medicaid claims processing, auditing, or researching experience + 2 years' experience ... to ensure successful submission and reconciliation of encounter submissions to Medicaid . Ensures encounter submissions meet or exceed all compliance standards via… more