- HCA Healthcare (Nashville, TN)
- …with respect to provider enrollment and billing errors, utilizing proper customer service protocol + Update and maintain data inappropriate Provider ... and integrity. We care like family! Jump-start your career as a Medicaid Provider Enrollment Specialist today with Parallon. **Benefits** Parallon, offers… more
- CVS Health (Richmond, VA)
- …risk. **Required Qualifications** - 1+ years of Credentialing experience -1+ years of Provider Data Service experience Demonstrated track record of ... data management processes. - Responds to network or provider /producer inquiries, including contracting and credentialing policy, procedures, credentialing status.… more
- Idaho Division of Human Resources (Boise, ID)
- …EXAMPLE OF DUTIES: + Analyzes claims data and reports to identify Medicaid provider and participant utilization patterns that may indicate program abuse. + ... crucial role in conducting preliminary investigations by reviewing claims data and medical records, reviewing provider billing...state Medicaid agency or working for a Medicaid provider in a position that required… more
- New York State Civil Service (Albany, NY)
- …Prepare and analyze background information to identify targets.* Examine and analyze fee-for- service and managed care documentation to ensure provider compliance ... NY HELP Yes Agency Medicaid Inspector General, NYS Office of the Title...outside the United States or its territories, you must provide independent verification of equivalency. This information can be… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …program policy. Manages the Prior Authorization Liaison (PAL) referral process for assigned Medicaid programs to ensure compliance. No Civil Service test scoreis ... May provide functional supervision in accordance with the Civil Service Allocation Criteria Memo. Location of Work: Department of Health and Hospitals.… more
- Mathematica (Columbus, OH)
- …related to monitoring and improving the following Medicaid programs: Medicaid payment and financing policies (fee-for- service base and supplemental payments, ... rigorous analytic thinking to the collection and interpretation of quantitative and qualitative data , including analysis of Medicaid administrative data and… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …compliance with program regulations. Administers the day-to-day operational functions of the Medicaid fee for service programs. Assures that program policy and ... accordance with the requirements of the Administrative Procedures Act. Implements Medicaid regulations directing provider participation standards and recipient… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …continued eligibility requests. Maintain work assignment and gather results of review to provide statistical and data for unit reports. Assist and/or complete ... procedures of the organization as well as State Civil Service rules, and all applicable federal and state laws....and/or directing inquirers to appropriate resources. Cross train to provide back up to the Medicaid Beneficiary… more
- Northwell Health (New Hyde Park, NY)
- **Req Number** 131934 Job Description Assists patient/family in completing Medicaid application. Assesses patient's eligibility for Medicaid . Verifies patient's ... + * Contacts patient/family and conducts interviews for the purpose of assessing Medicaid eligibility. + * Meets with and assists patient/family in completing … more
- Humana (Columbus, OH)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... This role will work horizontally across the organization, coordinating with Medicaid and Medicare leadership and clinical subject matter experts to synthesize,… more
- Public Consulting Group (Columbus, OH)
- …new streamlined modular certification (SMC) and outcomes-based certification (OBC). Our ideal Medicaid Consultant will provide oversight and direction for scope, ... achieve strategic goals to serve the public better. We provide the full spectrum of technology consulting services to...Business Enablement + Business Solutions + Project Assurance The Medicaid marketplace is changing, and PCG is at the… more
- Robert Half Accountemps (Southampton, MA)
- …* Regularly update and maintain customer credit records. * Handle inquiries related to Medicaid billing and provide resolution to any issues. * Accurately input ... Description We are offering an opportunity for a Medicaid Claims specialist in Southampton, Massachusetts. This role...data and manage numeric data entries. * Ensure the correct interpretation and application… more
- Humana (Columbus, OH)
- …The key responsibilities of the role include: + Refresh Medicaid inpatient data and tool monthly to provide best estimate utilization/PMPMs for the month ... for Medicaid markets The Actuarial Analyst 2, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around… more
- New York State Civil Service (Albany, NY)
- …year or more of permanent or contingent-permanent competitive service , or 55 b/c service as a Medicaid Integrity Specialist 1; OR current New York State ... NY HELP Yes Agency Medicaid Inspector General, NYS Office of the Title...current Eligibility Letter from the NYS Department of Civil Service , www.cs.ny.gov/rp55/ and be able to provide … more
- VNS Health (Manhattan, NY)
- OverviewContacts and assists VNS Health Plans members with Medicaid applications and recertification. Enters and updates member demographic information into the ... Works under general supervision. Compensation Range:$20.98 - $26.23 Hourly What We Provide + Referral bonus opportunities + Generous paid time off (PTO), starting… more
- CVS Health (Princeton, NJ)
- … specialties + Meet provider services requirements under this Agreement + Provide provider education and develop and deliver provider training + ... such as quality improvement projects, are included on project teams to identify provider perceived barriers and provide input on design and intervention test… more
- Abbott House (Bronx, NY)
- …Facilitate a single case agreement when a child is placed outside of the MMCP's service area or provider network Interact with clinical and billing staff Refer ... Job Summary: The Medicaid Managed Care Liaison is the primary contact...children for needed services and assist in provider selection Coordinate with health care providers, including school… more
- Staffing Solutions Organization (Albany, NY)
- …analytic exercises, and provide insight into the management and quality of data in the NYS Department of Health's Medicaid program. Comprehensive on-the-job ... Medicaid Program Advisor One Commerce Plaza, Albany, 99...Service Management principles preferred + Database architecture and data management experience preferred + Project Management certification or… more
- City of New York (New York, NY)
- …ARE HIRED PROVISIONALLY IN THIS TITLE, YOU MUST TAKE AND PASS THE CIVIL SERVICE EXAM, WHEN IT BECOMES AVAILABLE, TO BE ELIGIBLE FOR CONTINUED EMPLOYMENT. Infoline is ... HRA's telephone service center, which provides information on HRA's programs to...who speak to callers directly and are able to provide case specific information. Constituents can call the Infoline… more
- Conduent (Topeka, KS)
- …policies and procedures, call center processes, and other content related to Medicaid data entry and registration. Will continually measure training needs, ... of a culture where individuality is noticed and valued every day. ** Medicaid Eligibility Trainer** **Hourly rate $19.82/hr** Conducts training classes for employees… more