- Stanford Health Care (Palo Alto, CA)
- …Health Care job.** **A Brief Overview** The Single Path Coding (SPC) Specialist -Level 2 is an advanced coder position responsible for reviewing clinical ... HCPCS and the American Medical Association (AMA) CPT Assistant. The SPC Coding Specialist II serves as a subject matter expert in hospital and professional coding,… more
- Organon & Co. (Plymouth Meeting, PA)
- **Job Description** **The Position** The Contract Operations Sr. Specialist - US Market Access Contract Operations is responsible for overseeing the execution of ... or government channel contracts. + Experience with pricing and reimbursement, Medicare , Medicaid, and government pricing implications. + Broad understanding of US… more
- Moses/Weitzman Health System (Middletown, CT)
- …and collections office + In depth knowledge of CPT and ICD-10 Codes, Medicare and Medicaid billing rules. Insurance reimbursement methods, the claims appeal process, ... Microsoft Excel, Word, Access and Outlook This Position is available for remote work. **Organization Information:** Community Health Center, Inc. (CHC) with offices… more
- Commonwealth Care Alliance (Boston, MA)
- …appropriateness, efficiency and quality of the services provided. The LTSS Program Specialist will have a wide range of responsibilities including project management ... and (e)assistance to these external partners as necessary. The Specialist is expected to work with managers and staff...duties as assigned Working Conditions: - This is a remote or hybrid role with the expectation of working… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …to join the **Senior Care Outreach and Retention** team\! As a Pharmacy Specialist , you'll be the frontline of our Senior Care Team, guiding members through ... adherence and plan education to keep our members safe and healthy\! This remote position offers a Monday\-Friday work schedule where you will be making and… more
- Stanford Health Care (Palo Alto, CA)
- …billing, including federal and state regulations and guidelines, CMS (Centers for Medicare and Medicaid Services) and OIG (Office of Inspector General) compliance ... be removed from an account + Conducts audits for Medicare /Medicaid Cost Outlier accounts prior to billing, ensuring itemized...Licensure required . or + CCS - Certified Coding Specialist required . or + CPC and/or CCSP -… more
- Commonwealth Care Alliance (Boston, MA)
- …Engagement & Performance **Position Summary:** The Senior Provider Relations Specialist is responsible for building, maintaining and strengthening relationships with ... Conditions:** + Standard office conditions. + This is a remote or hybrid role with the expectation of working...expert of the team + Managed Care experience (preferably Medicare /Medicaid) + Experience in health plan provider relations +… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA-Claims Hiring for One Year Term **_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will not ... This role will ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for… more
- Molina Healthcare (Oshkosh, WI)
- **JOB DESCRIPTION** Candidate must reside in Wisconsin. Remote with field travel required in assigned territory. **Job Summary** Responsible for increasing ... membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare -Medicaid recipients within approved market areas to achieve… more
- University of Southern California (Alhambra, CA)
- As the center of clinical charge capture, the Revenue Integrity (RI) Specialist provides leadership to the daily CDM maintenance workflow between the various ... the standard policy for maintaining the CDM. The RI Specialist is responsible for the timely and accurate synchronization...provided. This includes ensuring all annual updates required by Medicare and other third-party payers are up to date.… more
- Marshfield Clinic (Marshfield, WI)
- …the most exciting missions in the world!** **Job Title:** Hospital Coding Specialist III ( Remote ) **Cost Center:** 101651098 System Support-Facility Coding ... be eligible for a sign-on bonus!**_** **JOB SUMMARY** The Hospital Coding Specialist III accurately codes inpatient conditions and procedures as documented in the… more
- Providence (NM)
- …the PSJH System Revenue Integrity Chargemaster (RICDM) Dept. team, the Senior CDM Specialist shall ensure that the Chargemaster (CDM) is consistent with all coding ... and billing regulations and accurately represents services provided. The Senior CDM Specialist acts as the liaison between the Hospital ministry and the PSJH System… more
- Guidehouse (Minneapolis, MN)
- …**Travel Required** **:** None **Clearance Required** **:** None This position is fully remote **What You Will Do** **:** + Under the direction of the Director ... services through efficient review and timely resolution of assigned Medicare and third party payer accounts that are subject...hold edits, and claim denials. **This position is 100% remote ** .Daily duties for this position include: + Responsible… more
- Trinity Health (Albany, NY)
- …Risk Adjustment Coding Specialist -St. Peter's Health Partners - Full-time - Remote **POSITION PURPOSE:** The Risk Adjustment Coding Specialist works in a ... while adhering to coding guidelines established by the Centers for Medicare and Medicaid Services (CMS). **SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:** **.… more
- Marshfield Clinic (Marshfield, WI)
- …most exciting missions in the world!** **Job Title:** SHP Pharmacy Benefits Specialist ( Remote in WI)) **Cost Center:** 682891381 SHP-Pharmacy **Scheduled Weekly ... **Job Description:** **JOB SUMMARY** The Security Health Plan (SHP) Pharmacy Benefit Specialist is responsible for the daily administration of the SHP pharmacy… more
- Molina Healthcare (NE)
- **Job Description** **Job Summary** The Sr Specialist , Member & Community Interventions oversees and implements new and existing clinical quality member intervention ... initiatives including all lines of business ( Medicare , Marketplace, Medicaid). Executes health plan's member and community quality focused interventions and programs… more
- Prime Therapeutics (Richmond, VA)
- …career? Come build the future of pharmacy with us. **Job Posting Title** Client Audit Specialist - Remote **Job Description** As a member of the Client Audit ... Management (CAM) team, the Client Audit Specialist is accountable for independently, or in collaboration with senior staff or compliance leader, managing regulatory… more
- TEKsystems (Houston, TX)
- Credit Underwriter - Remote Opportunity Location: Work From Home (Available in 47 states - excluding Vermont, North Dakota, and Hawaii) Employment Type: ... supporting a major mortgage program. This is a fully remote position offering flexibility and competitive pay. As a...accident, hospital indemnity, and/or critical illness supplement insurance * Medicare - free online resources for anyone who is… more
- Huron Consulting Group (Chicago, IL)
- …member of Huron's Research Office Team. As a Clinical Research Administrative Specialist II, you'll assist Huron's Research Office team in developing coverage ... You will also assist in review and feedback for Clinical Research Administrative Specialist I projects and will begin to support client contacts for client specific… more
- National Health Transport (Miami, FL)
- Summary: Ambulance Medical Billing Specialist is responsible for billing and collection processes for National Health Transport's ambulance trips. Ambulance Medical ... Billing Specialist answers inquiries from insurance companies, patients, and processes...+ Medical coding training and experience + Familiar with Medicare /Medicaid laws and billing + Certified Ambulance Coder helpful… more
