- AbbVie (Mettawa, IL)
- …patients covered under their numerous healthcare programs have access to our medicines. Medicaid is one of the largest of these programs. AbbVie contributes to the ... and disputes of a large volume of quarterly rebate claims within required timelines. Core Job Responsibilities: + Manage...is responsible for the accurate and timely payment of Medicaid rebates totaling $7 billion annually to state … more
- Aston Carter (Parsippany, NJ)
- Job Title: Medicaid Claims Analyst Job Description The ...rebates team is made up of the Director of Medicaid , a manager , and several team members. About ... Medicaid Claims Analyst is responsible for Medicaid Drug Rebate process which includes validating, verifying, disputing when necessary, and remitting payment… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Medicaid Claims Analyst Date: Aug 22, 2024 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 57784 **Who we are** ... people to make a difference with. **The opportunity** The Medicaid Claims Analyst is responsible for ... analyzes and documentation on assigned states/programs. Communicate to manager for key findings and changes to state programs.… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Medicaid Claims Analyst Date: Aug 24, 2024 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 57268 **Who we are** Teva ... us on our journey of growth! **The opportunity** The Medicaid Claims Analyst is responsible for ... analyzes and documentation on assigned states/programs. Communicate to manager for key findings and changes to state programs.… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Manager , Medicaid Compliance & Analytics Date: Aug 23, 2024 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 57826 ... a difference, and new people to make a difference with. **The opportunity** The Manager of Medicaid Compliance and Analytics will manage operations of … more
- Sumitomo Pharma (Columbus, OH)
- …the Medicaid rebate team in receiving, processing, validating, trouble-shooting Medicaid claims and dispute resolution with state agencies. This position ... dynamic, highly motivated, and experienced individual for the position of **Sr. Manager , Medicaid Contract Administration.** The Sr. Manager , Medicaid … more
- CVS Health (Princeton, NJ)
- …management skills + Understanding of health plan operations, including contracting, claims processing, encounter data processing, and Medicaid eligibility and ... care more personal, convenient and affordable. **Position Summary** The Behavioral Health Senior Manager of Network Relations is a key role on the Aetna Better… more
- CVS Health (Dallas, TX)
- …to helping you achieve your career goals._** **In this Texas Medicaid individual contributor role the contract negotiator:** + Negotiates competitive contracts ... and ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation and parameters, or accuracy of provider contract or… more
- Consulate Health Care (Norfolk, VA)
- …Health Care of Norfolk | Full Time **Looking for qualified Assistant Business Office Manager ( Medicaid Specialist) to join our team at the Consulate Health Care ... Norfolk!** We are searching for an **Assistant Business Office Manager ** to join our community that is resident and...the generation and submission of all network and insurance, claims , statements on a timely basis. + Produce UB92's… more
- CVS Health (King Of Prussia, PA)
- …issues regarding policies and procedures, plan design, contract language, service, claims or compensation issues, and provider education needs. + Optimizes ... are met and that escalated issues related but not limited to, claims payment, contract interpretation or parameters, and accuracy of provider contract or… more
- Humana (Indianapolis, IN)
- …The Provider Education & Outreach Representatives serve as the primary relationship manager with providers to ensure positive provider experience with Humana Healthy ... policies and procedures, explain Humana systems, etc. + Serves as primary relationship manager with LTSS and HCBS providers and/or PH and BH providers to ensure… more
- CVS Health (Trenton, NJ)
- …make health care more personal, convenient and affordable. **Position Summary** + The Medicaid VBS Network State Manager manages and oversees compliance with our ... the ability to work with others at all levels + Knowledge of Medicaid Regulatory Standards for Network Access, Credentialing, Claims Processing, Provider Appeals… more
- Humana (Columbus, OH)
- …determination of the appropriate courses of action. **Where you Come In** As a Claims Process Organization Project Manager II you will manage all aspects of ... **Become a part of our caring community and help us put health first** The Project Manager II manages all aspects of a project, from start to finish, so that it is… more
- Elevance Health (Columbus, OH)
- Nurse Utilization / Medical Management I - Medicaid (JR129062) **Location:** Candidates must reside within 50 miles or 1-hour commute each way of one of our relevant ... resources. Works with medical directors in interpreting appropriateness of care and accurate claims payment. Primary duties may include, but are not limited to: +… more
- Randstad US (Franklin, TN)
- edi scrum master (hipaa - medicare/ medicaid , edi - itxa, sterling) - franklin,tn. + franklin , tennessee + posted 4 days ago **job details** summary + $45 - $55 per ... Mapper, Performance Tuning, Production Support ANSI X12 HIPAA: 837 Claims (Institutional, Dental, Professional), 835 (Claim Payment/Remittance), 834 (Benefit… more
- Fallon Health (Worcester, MA)
- …be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the Elderly)- in ... define Coding Standards and best practices. Accept assignment from the Manager . Maintain strong interdepartmental relationships. Light travel may be required.… more
- Banner Health (AZ)
- …If you're looking to leverage your abilities - you belong at Banner Health. The Associate Manager Patient Financial Services Claims will manage a team of 10 - 12 ... Representatives working with United Healthcare (Commercial, Med Advantage & Medicaid ). Systems frequently used: FinThrive Collections Management, Med Series 4,… more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** **Accounting Clerk (Commercial Claims Follow-up) Full-Time M-F 9AM to 5PM East 42nd Street** Under the supervision of the Patient Financial ... Supervisor/ Manager , performs a variety of patient accounting functions, including...including but not limited to financial verification, preparation of Medicaid applications, billing, processing accounts, payment and/or charge posting,… more
- Dignity Health (Bakersfield, CA)
- …employer-match. Other benefits include Paid Time Off and Sick Leave. **Responsibilities** Assist Claims Manager in day to day supervision, support and monitoring ... the work in progress based on findings. This position reports to the Claims Manager . This position has supervisory responsibility over several Claims… more
- CHS (Clearwater, FL)
- …related to claims and calls and provides feedback to their Manager . + Maintains up-to-date working knowledge on regulatory requirements associated with billing ... **Overview** ** ** ** Claims and Call Auditor (Call Center QC) -...+ Knowledge of medical coding systems + Knowledge of Medicaid /Medicare Guidelines + Knowledge of billing rules and regulations.… more