Medicaid Claims Review Lead — Remote Eligible
Partner's Healthcare
Somerville, MA
- Remote job
Mass General Brigham Health Plan is seeking a Supervisor, Medicaid Claims Review to lead a high-performing team focused on Medicaid claims quality, payment accuracy, and adjudication integrity. This role oversees daily inventory and works with cross-functional teams to reduce rework across the enterprise. The position requires a Bachelor’s degree, 3–5 years in claims review, and leadership experience. Remote work option is available for approved U.S. #J-18808-Ljbffr Partner's Healthcare
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Medicaid Claims Review Lead — Remote Eligible in Somerville, MA vacancy
$79.56k - $115.72k
...Brigham Health Plan Supervisor, Medicaid Claims Review Mass General Brigham... ...with one of the world's leading integrated healthcare systems... ...accuracy, compliance, and eligibility, ensuring that claims are processed... ...position is eligible for remote work from approved U.S....Remote workClaimsFull timeWork at officeMonday to FridayFlexible hoursShift work$19 - $23 per hour
...Medicaid Eligibility Representative Meduit is a national leader in healthcare... ...experience (In-office or Remote) ~ High School Diploma/GED... ...Experience with medical billing/claims processing Time... ...further information, please review the Know Your Rights notice...Remote workClaimsHourly payWork at officeLocal areaMonday to FridayAfternoon shift- Boomerang Healthcare’s Manager, Eligibility and Benefits role at Walnut Creek, CA is a senior administrative position overseeing eligibility... ...clinical specialties. You will standardize workflows, reduce claim denials, and ensure accurate patient liability is determined before...Remote jobClaims
$66k - $106k
...investigation, and medical review to detect, prevent,... ...clinical judgement to claim payment decisions. Responsibilities... ...to uncover problems in Medicaid payments made to... ...galaxy. As the world’s leading mission capability... ...position, employees may be eligible for overtime, shift...Remote workClaimsContract workShift workNight shift$23 - $26 per hour
...Position: Medicaid Collections Specialist (Hospital Revenue... ...Cycle) Location: Remote (U.S. Remote;... ...select states are not eligible) Pay Range: $23.00 –... ...facilities, ensuring accurate claim resolution and maximizing... ...resolution strategy Review claim edits and reimbursement...Remote workClaimsHourly payTemporary workLocal areaAddison Group
Mesquite, TXa month ago$5,000 per month
...Amerita, Inc. is a leading provider in home Infusion... ...limited to Medicare, Medicaid, commercial insurances... ...teams and all denied claims are worked within 7 days... ...be given priority Reviews insurance remittance advices... ...adjustments (within eligible guidelines),...Remote jobClaimsWork at officeMonday to FridayFlexible hoursShift work- Peraton is seeking a Medical Reviewer for SafeGuard Services to conduct medical record reviews, apply clinical judgment to claim payment decisions, and support fraud investigations... ...States. Responsibilities include researching Medicaid regulations, identifying improper...Remote workClaims
$70.1k - $126.2k
...flexibility. This is a remote role anywhere... ...for Medicare & Medicaid Services (“CMS”) guidelines... ...purposes. Reviews investigative interviews... ...proactive leads for investigations... ...understanding of managed care claims processing systems... ...to program eligibility. Centene is an...Remote workClaimsFull timePart timeWork at officeFlexible hours- ...Health Plan Holding Company, Inc. seeks a Supervisor, Medicaid Claims Review to lead a high‑performing team focused on claims quality,... ..., 3-5 years in claims review, and strong leadership. Remote work eligibility, with standard hours 8:30-5 ET, Monday-Friday. #J-18...Remote jobClaimsMonday to Friday
$35 - $37 per hour
...Lead RN Reviewer Cohere's Service Operations team is responsible for ensuring that our healthcare... ...flexible leadership style suited for a remote, fast-paced environment Pay &... ...authorization data with post-service claims validation, we're creating a transparent...Remote workClaimsHourly payFlexible hoursVenturefizz Product Management Community
United States1 day ago$91.7k - $163.7k
...together. Psychologist Peer Reviewer is for an Outpatient... ...to Commercial, Medicaid, and/or Medicare cases... ...the flexibility to work remotely* as you take on some tough... ...authorizations, file claims, conduct peer reviews,... ...are subject to eligibility requirements). No matter...Remote workClaimsMinimum wageFull timeWork experience placementWork at officeLocal areaWork from homeMonday to Friday- ...Position Summary The Indiana Medicaid Team Lead is dedicated to the Medicaid... ...to ensure Medicaid claims are billed, followed up, appealed... ...documentation expectations. Review inventory by payer, aging,... ...-specific claim submission, eligibility, authorization, denial,...ClaimsImmediate start
RevOne Companies
Greenwood, IN10 days ago $100k - $231.54k
...community at a time. Lead Director, Network... ...‑related claim denials, optimizing... ...strategies for Medicare, Medicaid, and commercial... ...delegation discussions and review Statements of Work... ...office or remote work environment.... ...This position is eligible for a CVS Health bonus...Remote workClaimsHourly payFull timeTemporary workWork at officeLocal area$21.25 - $31.92 per hour
Lead Accounts Receivable Claims Specialist (Chesapeake Specialty Care) Job... ...009820 Full-Time Remote Hourly Range : $21.2... ...of payment denials. Review and resolve complex... ...commercial, Medicare, Medicaid, and Tricare. Advanced... ...will not be eligible for the upper end of...Remote workClaimsHourly payFull timeWork experience placementWork at office- ...Medicaide Advoctage will be responsible for reviewing the Medicaid Pending applications and Medicaid... ...facilities to ensure Medicaid eligibility to obtain timely coverage and approvals... ...BOM and ABOM in the areas of billing, claims, eligibility and authorization process...Remote workClaimsFull timeWork at office
OPCO Skilled Management
Albuquerque, NM10 days ago - ...LOCATION: Remote - This is a home based, virtual position that... ...generating high-quality recoverable claims by reviewing medical records and other... ...communication skills. Medicaid experience is a plus.... ...position is exempt and is not eligible for overtime compensation....Remote workClaimsLive inWork from homeMonday to Friday
Vaya Health
United States21 hours ago $144.06k - $205.8k
...operational readiness. The Lead, Access Marketing,... ...boards, field feedback, claims data, and customer engagement... ...and activating eligible patients.Design and lead... ...timelines, promotional review processes, and multiple... ...San Francisco, CA, or remote.At Astellas we recognize...Remote workClaimsWork at officeWork from homeWorldwide$100k - $140k
...Medical Reviewer (Pharmacist) - Remote CA It takes great medical minds to create... ...supports pharmacy review, claim adjudication, drug rebate... ...suspension from Medicare, Medicaid, or pharmacy practice in California... ...full-time candidates are eligible for our generous, flexible...Remote jobClaimsFull timeWork from homeHome officeMonday to FridayFlexible hours- ...United States of America, Remote (US), Santa Clara,... ...Regulatory Affairs Program Lead to support our... ...This includes conducting reviews and providing expert regulatory... ..., support of claims, content labeling, and... ...respective plans, employees are eligible to participate in the...Remote workClaimsFull timeLocal areaImmediate start
$100k - $140k
...looking for an experienced Lead, Ceded Reinsurance... ...activities.Prepare and/or review and analyze monthly and... ...monitor reinsurance claims processing, including responding... ...: it may be fully remote/hybrid. If you are... ...compensation opportunities. Eligibility for these programs...Remote workClaimsFull timeTemporary workLocal areaFlexible hours2 days per week3 days per week- ...This is a fully remote position with a U.S. based company. The Medicaid Team Lead is primarily responsible for overseeing cases... ...management of their team of Eligibility & Application Support Specialists... ...and annual performance reviews; address disciplinary issues when...Remote workFull time
Eldercare Resource Planning
Remote3 days ago $112.6k - $239.8k
...Engagement Lead Forensic Accounting & Claims Services Consultant We are seeking a... ...any of our US offices or Remote. As an Engagement Lead... ...plans to address them. Review and refine client deliverables... ...salary, this position may be eligible for performance-based...Remote jobClaimsMinimum wageFlexible hours- ...Albuquerque, NM seeks a Medicaide Advocate to review Medicaid pending applications and renewals for assigned facilities, ensuring eligibility for timely coverage and approvals. You... ...AR staff, BOM and ABOM in billing, claims, eligibility and authorization across Medicaid...Claims
$80k - $170.7k
...Sr. Medicaid Business Analyst NTT DATA Services... ...Include: Review project artifacts/... ...and/or lead in the creation of... ...administration or claims or financial reporting... ...pay range for this remote role is $80,000 -$... ...This position is eligible for company benefits...Remote workClaimsTemporary workFlexible hoursSierra Systems, An Ntt Data Company
United States2 days ago$23.56 - $25.77 per hour
...Medicaid Billing Clerk It's fun to work in a company where people... ...provider is to assist those eligible Medicaid recipients to choose... ...Responsibilities Billing Operations & Claims Management Prepare and... .... Adjust patient bills by reviewing remittance advice and...Remote workClaimsLocal areaPublic Partnerships | PPL
United States3 days ago$135.23k - $150.25k
...TeamEversource is looking for a Lead Project Controls,... ...project baseline.Reviewing, evaluating, and reporting... ...merit of out-of-scope claims and reasonableness of... ...for certain roles. Eligibility is based on job responsibilities... ...to roles approved for remote work and are subject...Remote workClaimsFull timeContract workFor contractorsH1bWork at office- Avēsis is seeking a Claims Supervisor to provide direct oversight... ...adherence to contract standards. Remote role requiring 3+ years of... ..., plus knowledge of Medicare/Medicaid terminology. Competitive pay... ...apply with robust benefits for eligible employees. #J-18808-Ljbffr...Remote jobClaimsContract work
- ..., and secure ITOM solutions; review and approve all ITOM design decisions... .../CMDB Ownership & Health: Lead CMDB design, governance, and... ...process, will not be eligible to claim related fees and the submitted... ...allow, CSC offers hybrid or remote work schedules in alignment with...Remote workClaimsLocal areaWorldwide
- ...Not everyone can claim to feed the world, but it is... ...seeking an experienced Lead Security Operations Analyst... ...Conduct post incident reviews to identify gaps,... ...Purchase Plan offering eligible employees the ability to... ...Workplace As a designated remote role, this position is...Remote workClaimsHome officeFlexible hours
$65k - $75k
...challenging work? Our company, a leading parent organization that owns and... ...across North America, seeks a new REVIEW TEAM MANAGER! FLEXIBLE POSITION - REMOTE OR HYBRID ROLE REPORTS TO: Director... ...will serve as a member of the Claims Force team (formerly known as Quality...Remote workClaimsTemporary workWork at officeLocal areaWork from homeFlexible hoursPaul Davis Restoration, Inc.
Jacksonville, FL7 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Medicaid Claims Review Lead — Remote Eligible. Be the first to apply!
Related searches
- healthcare claims Somerville, MA
- veterans claims Somerville, MA
- claims processing Somerville, MA
- medical claims auditor Somerville, MA
- senior network engineer remote Somerville, MA
- remote legal intern Somerville, MA
- remote customer service chat Somerville, MA
- remote software sales Somerville, MA
- full time remote Somerville, MA
- marketing intern remote Somerville, MA