- National Health Care Associates (Stafford Springs, CT)
- …appreciated. We invite you to join our team! **-** **What You'll Do:** As a Medicaid Specialist , you will support the center's business office in processing ... are valued and appreciated, we invite you to join our team as a Medicaid Specialist **-** **What We Offer** As an affiliate of National Health Care, our… more
- Hartford HealthCare (Mansfield Center, CT)
- …become part of Connecticut's most comprehensive healthcare network as a Pre-Billing Specialist . The Pre-Billing Specialist is responsible for reviewing and ... system prior to claim submission. This role ensures compliance with Medicare, Medicaid , and other Commercial payer requirements, helping to prevent billing errors… more
- State of Connecticut, Department of Administrative Services (Norwich, CT)
- Developmental Services Resource Management Specialist Hybrid Recruitment # 251222-1609EG-001 Location Norwich, CT Date Opened 12/24/2025 12:00:00 AM Salary $70,012* ... time job opportunity for a Developmental Services Resource Management Specialist (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=1609EG&R1=&R3=) , supporting the Private Administration Division in… more
- Prime Therapeutics (Providence, RI)
- …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 and/or… more
- Highmark Health (Providence, RI)
- …medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation ... Professional Coder (CPC) + Certified Risk Coder (CRC) + Certified Coding Specialist (CCS) + Registered Health Information Technician (RHIT) **Preferred** + None… more
- Charter Care Health Partners (Providence, RI)
- …The specialist will be familiar with and understand Medicare, Medicaid , other government payers, Commercial and HMO/PPO Payers guidelines and principals. ... Education: High school graduate or GED required. Associate's level degree preferred. Experience: Prior experience working in a related role in a medical office or other health care related organization. 2-3 years of prior insurance verification and… more
- Cardinal Health (Providence, RI)
- …secondary insurance company when necessary. + Bills supplemental insurances including all Medicaid states on paper and online. + Oversees appeals and denials ... management to maximize revenue recovery and minimize financial leakage, ensuring all claims are accurately processed and followed up in a timely manner. + Manages billing queue as assigned in the appropriate system. + Investigates and updates the system with… more
- Public Consulting Group (Providence, RI)
- …sector. To learn more, visit www.publicconsultinggroup.com . Engagement Operations - Training Specialist This role is focused on supporting the training needs of our ... will demonstrate the capacity for developing training content, facilitating school-based Medicaid program concepts and being a key contributor to the development… more
- National Health Care Associates (Stafford Springs, CT)
- …Direct care in a long-term care setting, MDS Coordinator, Clinical Reimbursement Specialist or Nurse Assessment Coordinator experience preferred + Knowledge of state ... federal regulations governing the MDS, Electronic Medical Record (EMR), PDP, MDS 3.0, Medicaid and Medicare requirements helpful + Interest in the nursing needs of… more
- Hartford HealthCare (Norwich, CT)
- …and standards by The Joint Commission (TJC), Center for Medicare and Medicaid (CMS), and Connecticut Department of Public Health (DPH). *Education: *Associate's ... *National Association Medical Staff Services (NAMSS) Certified Provider Credentialing Specialist (CPCS) required. If not certified, obtain certification within 1… more
- CVS Health (Woonsocket, RI)
- …submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, ... + CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist -Physician) required. **Preferred Qualifications** + AA/AS or equivalent experience +… more
- Evolent (Providence, RI)
- …Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the ... or sanction by any state or federal health care program, including Medicare or Medicaid , and is not identified as an "excluded person" by the Office of Inspector… more