- Omaha Children's Hospital (Omaha, NE)
- …with payer reps, internal departments, and vendors. * Stay informed of CMS, Medicaid , HIPAA, and payer regulations affecting payment posting and reimbursement. * ... is to improve the life of every child through exceptional care, advocacy, research and education. As the state's only full-service pediatric healthcare center, we… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Collections Specialist I - Medicaid is responsible for performing collection follow-up on outstanding insurance balances, identifying claim ... follow-up on outstanding insurance balances within the required timeframe, obtaining payment confirmation or required documentation. + Documents all actions taken on… more
- University of Rochester (Rochester, NY)
- …discrepancies, and creates general ledger deposit receipts. Follows up on missed payment deadlines. Communicates with University Finance and Information Systems ... refunds. **ESSENTIAL FUNCTIONS** + Balances and posts electronic file payments from Medicare, Medicaid , Blue Cross, and MVP. Balances check payments, identifies… more
- Somatus (Mclean, VA)
- …care?** Somatus is on the hunt for a visionary **Senior Vice President of Finance ** to lead at the crossroads of strategy, innovation, and impact. This isn't just ... a finance role. This is a chance to architect the...Design provider incentives that balance impact and budget + ** Payment Integrity Product Areas:** Clinical Claim Review, Payment… more
- City of New York (New York, NY)
- …regulatory, and/or research policy and analysis - The regulation and financing of hospitals and other healthcare facilities and businesses at the federal, state, ... promote high-value care - Civil rights and non-discrimination in healthcare - Medicaid policy and strategy - Outstanding research , analytical, and writing… more
- University of Rochester (Rochester, NY)
- …that include but are not limited to pre-certifications, Utilization Management, Medicaid Pending, third party payer issues, and denials/appeal processes. Involves ... with assigned area, Financial Assistance, Social Work, Utilization Management, Medicaid Enrollment & Outreach, patients, families, third-party payers, and… more
- University of Michigan (Ann Arbor, MI)
- …concerns, pre-screening eligibility for MSupport, cash collections, establishing payment agreements, providing Hospital and Professional charge estimates, and ... and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan,… more
- Humana (Washington, DC)
- …The team has a strong dotted-line partnership with the Medicare and Medicaid organization, Humana's largest, which comprises over 80% of the company's total ... an experienced team member to support delivering some of Medicare and Medicaid 's highest priority projects and initiatives, with an emphasis on Medicare Advantage… more
- Mount Sinai Health System (New York, NY)
- …and procedures provided to patients are accurately documented, coded, and submitted for payment . This position plays a key role in ensuring the financial health and ... insurance and governmental programs, regulations, and billing processes (eg, Medicare, Medicaid , etc.), managed care contracts and coordination of benefits is… more
- Edwards Lifesciences (Raleigh, NC)
- …individual will also support the health care providers in obtaining optimal reimbursement ( payment rates and market access) by serving as a knowledgeable resource in ... coding, coverage and payment , as well as, an intermediary to payers including...for Medicare Services (CMS) and/or Medicare Administrative Contractors (MAC), Medicaid , Veteran Affairs (VA) and commercial payers. **The Director,… more
- Mount Sinai Health System (New York, NY)
- …largest US health systems with a strong reputation for quality of care and research . We have over 38,000 employees working together to provide billions of dollars in ... within Mount Sinai. The team includes 400+ employees with clinical, contracting, finance , IT, analytics, operations, and product development expertise. MSHP is a… more
- University of Rochester (Rochester, NY)
- …+ Identify and confirm uninsured and underinsured patients for appropriate referral to Medicaid Enrollment & Outreach for possible Medicaid application and /or ... Counseling responsible areas and perform necessary follow-up to secure payment . + Notify and monitor patients COBRA entitlement and...skills to solve unique and complex problems. + Re-check Medicaid eligibility every 30 days for active coverage. +… more
- Humana (Little Rock, AR)
- …accuracy and predictability. + Collaborating with cross-functional teams (Product, Finance , Operations) to ensure data consistency, governance, and alignment with ... to drive business outcomes and decisions + Experience in Medicare/ Medicaid , CMS (Centers for Medicare & Medicaid ...Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide… more
- City of New York (New York, NY)
- …housing, and assistance with applying for public benefits and services including Medicaid , food stamps and cash assistance. HASA also provides vocational services ... will: - Under the direction of the Director of Finance , plan, direct, and monitor the activities of professional...monitor the activities of professional staff engaged in fiscal research and quantitative analysis of invoices related to the… more
- Molina Healthcare (Covington, KY)
- …according to the SIU's standards. Position must have thorough knowledge of Medicaid /Medicare/Marketplace health coverage audit policies and be able to apply them in ... ensuring program compliance via payment integrity programs. The position must have the ability to determine correct coding, documentation, potential fraud, abuse,… more
- Covenant Health Inc. (Knoxville, TN)
- …claims charging, coding, and billing in order to ensure compliance. + Performs research and analysis of charges, CPT coding, modifiers and billing processes to ... ensure compliance with Medicare, Medicaid guidelines and other insurance payors and to maximize...applicable. + Coordinates with appropriate parties the complete/ partial payment or repayment of the claims, as described in… more
- Hartford HealthCare (Newington, CT)
- …and objectives which is not limited to HHC receiving the appropriate payment . *_Position Responsibilities:_* *Key Areas of Responsibility* Functions as a high-level ... in denials. When a claim is denied; A. Takes appropriate action for payment resolution; documents all activity in accordance with standard work B. Initiates,… more
- Omaha Children's Hospital (Omaha, NE)
- …compliance with Resident reporting + Continually monitor changes in regulations and payment methodologies + Conducts research on Federal and State ... is to improve the life of every child through exceptional care, advocacy, research and education. As the state's only full-service pediatric healthcare center, we… more
- Rush University Medical Center (Chicago, IL)
- …depending on the circumstances of each case. **Summary:** Responsible for daily payment posting and reconciliation to ensure accurate accounts receivable. The Cash ... system. In this position it is necessary to observe insurance and patient payment trends and reports specific to their supervisor or manager. Actively supports new… more
- Care Plus NJ (Paramus, NJ)
- …of each plan. Job Summary: As an Accounts Receivable Specialist in our Finance Department, you will be responsible for meeting monthly collection goals by following ... patient accounts and reimbursement. The role requires strong knowledge of NJ Medicaid and Medicare billing, collaboration with clinical and executive teams, and… more