• HIM Audit and Education Specialist

    Hartford HealthCare (Farmington, CT)
    …common practices across the system. *_Position Summary:_* The Audit & Education Specialist develops and implements an effective and comprehensive audit & education ... and healthcare revenue cycle industry practices. The audit and education specialist will support documentation practices that comply with CMS risk adjustment… more
    Hartford HealthCare (03/05/25)
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  • Billing Specialist

    Masonicare (Wallingford, CT)
    Billing Specialist Job Location: Wallingford Center, Connecticut Billing Specialist Masonicare Corporate Services - Wallingford, CT Day Shift / 40hrs/wk **THIS ... IS ON-SITE** Under general supervision from Patient Accounts Management, The Billing Specialist performs a variety of complex operations related to the eligibility,… more
    Masonicare (03/04/25)
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  • Value-Based Reimbursement Specialist

    Highmark Health (Hartford, CT)
    …goals including but not limited to Government Markets (STARS, ACA, CHIP, Medicaid DE) and Enterprise Quality, Safety, and Values (Health Outcomes Measures). Provide ... share models and will be implemented for the Organization's Medicare Advantage, Medicaid , ACA, and commercial populations with the goal of maximizing quality while… more
    Highmark Health (02/25/25)
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  • Hierarchical Condition Category (HCC) Coding…

    Highmark Health (Hartford, CT)
    …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
    Highmark Health (03/04/25)
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  • Manager Rebate Pharmacy Operations

    Prime Therapeutics (Hartford, CT)
    …management. Enforces teamwork across all internal departments, as well as with Medicaid Clients, and an in-depth understanding of all rebate programs, trends, and ... state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each...department are achieved. + Works with Quality and Training specialist to refine and improve any processes that effect… more
    Prime Therapeutics (02/05/25)
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  • Special Investigation Unit Coding Director (Aetna…

    CVS Health (Hartford, CT)
    …providing guidance and support to maintain compliance with Medicare and Medicaid regulations. Your expertise will be crucial in optimizing coding processes ... diagnoses in compliance with federal and state regulations, including Medicare and Medicaid guidelines. * Develop and implement efficient coding workflows to enhance… more
    CVS Health (02/21/25)
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  • Financial Counselor / PA Self Pay

    Hartford HealthCare (Farmington, CT)
    …a multi-entity hospital and professional office environment, the Financial Counseling Specialist is responsible for analysis, investigation and resolution of patient ... and transfers. 3. Performs pre bad debt screening (reviews accounts for Medicaid Eligibility and/or bad debt vs. charity care). 4. Updates insurance information… more
    Hartford HealthCare (02/12/25)
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  • MDS - Nurse Assessment Coordinator (RN)

    National Health Care Associates (East Hartford, 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
    National Health Care Associates (02/25/25)
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  • Field Medical Director, Interventional Cardiology…

    Evolent (Hartford, CT)
    …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
    Evolent (01/30/25)
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