Provider Enrollment Specialist: Payer & CMS Coordination
Ventra Health, Inc.
Ventra Health, Inc. is seeking a Provider Enrollment Specialist to work with the Provider Enrollment Manager to identify and resolve payer enrollment issues and denials, contacting CMS and other payers via phone, email, or web. You will manage CMS Medicare and State Medicaid applications, track revalidation dates, maintain provider demographics across enrollment systems, and collaborate with Clients and Revenue Cycle Management to keep enrollment active and error-free. #J-18808-Ljbffr Ventra Health, Inc.
$55k - $65k
...have an immediate opening for a Senior Payer Enrollment Specialist to join our remote team at US... ...commensurate with experience) This role provides the opportunity to grow within a nationally... ..., and APPs across insurance plans Coordinate the addition of new service locations...SuggestedFull timeContract workPart timeWork at officeImmediate startRemote workMonday to Friday- DescriptionThe Provider Enrollment Analyst (I) is responsible for coordinating the provider enrollment and payer credentialing efforts for contracted FPA providers with Medicare and... ...ResponsibilitiesEnrolls and terminates providers with CMS and other government programs by...CmsHourly payTraineeshipLocal area
$20 - $30 per hour
...candidates for this Enrollment Ancillary Coordinator position. This position... ...services are provided. Maintains and updates... ...mentoring to the Enrollment Specialists and Ancillary... ...the understanding of payer credentialing nuances... ...hospital. Must have CMS, MD Staff, Adobe Pro...CmsPermanent employmentContract workWork at officeLocal areaRemote work$55k - $65k
...the leading virtual medical practice for women and children, providing care across pregnancy, postpartum, pediatrics, menopause,... ...families nationwide. About the Role Your North Star: Manage payer enrollments, and payer re-enrollments across clinician types for our existing...SuggestedRemote workFlexible hours$50k - $70k
...care, and accessibility. We don't just provide therapy; we empower seniors to... ...Position Summary The Provider Enrollment & Credentialing Specialist is a vital role that ensures our clinicians... ..., a deep understanding of Medicare/CMS guidelines, and the ability to navigate...CmsRemote work$126.42k - $189.63k
...Health community. Working at Alignment Health provides an opportunity to do work that really... .... Together. The Director of Provider Enrollment is responsible for leading provider enrollment... ...enrollment operations comply with CMS, NCQA, State, and accreditation requirements...CmsContract work- EyeCare Partners is the nation’s leading provider of clinically integrated eye care. Our... ..., visit Job Title: Provider Enrollment Specialist MUST LIVE IN ONE OF OUR 18 States:... ...Responsibilities Enroll providers with payers by providing information to the payers...Live inWork at officeImmediate startRemote workFlexible hours
- ...goals, we're looking for a Payer Credentialing Specialist to join our Operations... ...credentialing providers across a number of geographies... ...certifications, and work history. Coordinate payer enrollment applications and updates... ...compliance with NCQA, CMS, state, and payer-...CmsLocal areaRemote workWork from home
- ...seeking an experienced Provider Credentialing Specialist to support U.S.-... ...understand the full provider enrollment lifecycle, from... ...-credentialing and payer follow-up, and who... ...resolve outstanding items Coordinate with providers to... ...with PECOS and CMS enrollment portals Experience...CmsFull timeContract workWork at officeRemote workHome office
- Gainwell Technologies LLC is seeking a Provider Enrollment Analyst to support healthcare provider enrollment operations remotely within the United States. The role involves reviewing, processing, and maintaining accurate enrollment data in line with policies and regulatory...Remote job
- ...to work safely through coordinated, clinically... ...Services, a leading national provider of investigative and risk... ...Medical Cost Projection Specialist to coordinate and... ...accurate, compliant with CMS guidelines, and serve... ...and Medicare Secondary Payer (MSP) regulations. Utilize...CmsFull timeWork at officeRemote work
$66.3k - $79.8k
...accuracy standards are met. Coordinates efficient functioning of day-... ...appeals to enrollees and/or providers. Assists with collecting and... ...Medicare and Medicaid Services (CMS), Independent Review Entities... ...from Medicaid, Medicare, other payers, and/or professional medical...CmsWork experience placementWork at officeFlexible hours$21 - $22 per hour
...Position: Guest Eligibility Specialist I Job Type: Full-Time... ...on authorizations per payer portals, and faxing... ...prior authorization. Provide feedback to... ...Working knowledge of CMS guidelines, contracted... ...dexterity; eye-hand-foot coordination, use of corrected vision...CmsHourly payPermanent employmentFull timeTemporary workWork at officeRemote workMonday to FridayShift work- ...Summary: The Charge Capture Specialist II is responsible for... ...and requirements, including CMS, the State, and payer regulations related to these... ...coding in Charge Review, providing ongoing education to charging... ...charging opportunities in coordination with assigned departments...CmsWork at officeShift work
$55.6k - $92.6k
...pharmaceutical manufacturers, providers, pharmacies, governments,... ...Description The Membership Operations Specialist is an entry-level individual... ...intake, triage, follow-up coordination, and administrative support.... ...knowledge of GPO, enrollment, and manufacturer workflows...Full timeContract workWork experience placementH1bWork at officeRemote work2 days per week- ...own terms. The Care Management Coordinator is expected to ensure high... ...compliance with all departmental and CMS/DOH regulatory requirements.... ...vendors. Processes all newly enrolled cases according to... ...services/supplies. Coordinates and provides service authorizations to...Cms
- ...Reports to: Building Principal The Enrollment Specialist is charged with recruiting, selecting, and enrolling eligible families... ...based location. The enrollment specialist also creates, provides, and coordinates services and activities with families and communities that...Work at officeLocal area
- MJHS in New York, NY seeks an A&G Coordinator to investigate and respond to member and provider appeals and grievances under CMS and DOH rules. In a non-clinical role, you will help ensure timely decisions and accurate documentation. You will determine the appropriate...Cms
- ...discrepancies, or compliance issues. Verify that services provided are correctly documented, coded, and billed according to payer and regulatory requirements. Work to maximize... ...with healthcare regulations, including CMS (Centers for Medicare & Medicaid Services) and third...Cms
- ...Certified Clinical Documentation Specialist (CCDS) through the... ...with CDI Educator/Manager for provider educational opportunities. As... ...physician, nurse, or patient care coordinator by utilizing the appropriate... ...queries Promotes compliance with CMS, Medicare documentation, and...CmsWork at officeShift work
- .... We partner with healthcare providers to leverage automation and intelligence... ...coding guidelines and payer policy. This role operates in... ...targets.The Coding Specialist also resolves coding-related... ...full compliance with HIPAA, CMS regulations, and fraud/abuse...CmsHourly payRemote workFlexible hoursShift work
- ...fighting poverty and income inequality by providing New Yorkers in need with essential... ...line. Working under direction of the Enrollment Specialist Supervisor for Fair Fares, the... ...questions and concerns in a timely manner. Coordinates communication around site‑specific...Work at officeLocal areaMonday to FridayShift work
$135.79k - $178.23k
...Manager, Revenue Cycle Management, Provider Operations New York, New... ..., CCI/NCCI edits, and payer requirements. Establish and... ...Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist... ...with credentialing and payer enrollment processes and their...CmsFull timeWork at officeFlexible hours$23 - $25 per hour
...healthcare organization dedicated to providing compassionate and patient-centered care... ...are currently seeking a Health Home Enrollment Specialist to join our growing team. This role... ...program benefits, obtaining consent, and coordinating the necessary documentation. The role...Hourly payWork at officeWork from home$27.29 - $27.86 per hour
.... Overview Our Data Collection Coordinator will be responsible for the issuing... ...Discharge Appeal Rights (CMS - 4105-F) to Medicare beneficiaries, patients enrolled in Medicare Advantage and other... ...beneficiaries with Medicare as a secondary payer. Responsibilities Collaborate...Cms$21 - $24 per hour
...experienced Financial Management Service provider is to assist those eligible Medicaid... ..., Florida. Job Summary: The Enrollment Specialist serves as the primary point of contact... ...facilitates timely and accurate enrollment by coordinating required documentation, resolving...Contract workWork at officeLocal areaRemote work- ...ultimate healthcare experience that provides our members, their families,... .... JOB SUMMARY: The Field Coordinator is an essential team member... ...with the care of all members enrolled in CPHL’s managed care plans.... ...with CPHL policies, NY State, CMS, and Federal regulations...CmsWork at office
$40k - $44k
...to excellence, respect, and providing high-quality, personalized health... ...The Care Management Coordinator is expected to ensure high quality... ...compliance with all departmental and CMS/DOH regulatory requirements.... ...vendors. Processes all newly enrolled cases according to...CmsFull timePart timeFlexible hours- Cortica is seeking an Enrollment Coordinator to serve as the first point of contact for families seeking care. You will guide families through... ...processing, while collaborating with scheduling teams and providers to meet service level agreements and support #J-18808-Ljbffr...Remote job
- ...About the Role The Medical Coding Specialist is responsible for independently reviewing, analyzing... ...applying established coding guidelines, payer requirements, and organizational... ...with appropriate modifiers for services provided in the professional fee environment. Reviews...CmsHourly payTemporary workWork at officeLocal areaImmediate start
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