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- ...– Catoosa, OK Full‑time Modern Medical Supply is a Medicare‑enrolled DME supplier specializing in diabetes care, CGMs,... ...The Medical Biller will be responsible for tasks such as processing medical claims, reviewing and resolving claim denials, verifying insurance...ClaimsFull time
Modern Medical Supply
Catoosa, OK4 days ago - ...multilingual are strongly encouraged to apply. Medicare Billing Requirement Candidates must be... ...to complete the Medicare enrollment process. Responsibilities Provide direct psychotherapy... ...personnel to ensure authorizations and claims are processed appropriately Provide...ClaimsExtra income
Making Opportunity Count Inc
Fitchburg, MA13 hours ago - ...Job Title: Supervisor, Processing Operations Number of Positions: 1 Location: Farmington Hills, MI Location Specifics... ...as the subject matter expert and liaison for data entry and claims processing systems utilized within the Processing Center operation...ClaimsLocal areaFlexible hours
Delta Dental of Michigan
Farmington Hills, MI8 hours agonew $43k - $56.2k
...you will: Ensure the coordination of claim activities and designated agencies, and the... ...monthly accounts receivable, and process claims to obtain zero balances. Clear... ...encompassing all aspects of insurance and non-Medicare claims processing. Prepare input data...ClaimsBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workHome officeFlexible hoursHumana
Jefferson City, MO3 days ago- ...double 5-star rating from the Centers for Medicare and Medicaid Services. Position... ...Summary: The position is responsible for processing billings on behalf of the patient,... ...as well as following up on outstanding claims. This position will serve as a liaison with...ClaimsWork at officeMonday to FridayShift workDay shift
Avera Health
Sioux Falls, SD4 days ago - ...Billing Specialist Submit claims to insurance payers including primary, secondary, and tertiary (e.g., Medicare, Medicaid, Blue Cross, Workers' Comp, and commercial carriers... ...bill secondary or tertiary insurance. Process patient statements and respond to billing inquiries...Claims
Texas Institute for Surgery
Dallas, TX18 hours ago - ...A healthcare company in Tacoma, WA seeks a Claims Support Specialist to manage claims adjustment activities, ensure timely processing, and assist with efficiency improvements. The ideal candidate will have at least 1 year of experience in a clerical role within claims...ClaimsHourly payWork at office
Molina Healthcare
Tacoma, WA18 hours ago $87k - $106.6k
...models support monthly financial close processes, budget development, and quarterly forecasts... ...will play a key role in reviewing Medicare Advantage financial results, with a focus... ...prior period development for revenue and claims Enhance and maintain medical economics...ClaimsRemote workagilon health
Columbus, OH3 days ago- ...Knowledge of hospital billing processes, CPT/ICD codes, and DRG reimbursement. Familiarity with payer guidelines such as Medicare, Medi-Cal and commercial payers Strong communication... ...to detail and ability to analyze claim denials and payment variances....ClaimsWork at office
Pacer Group
Pomona, CA4 days ago - ...sponsored health insurance programsincluding Medicare, Medicaid, and PACEin the region.... ...meetings. Oversees intake and enrollment process for prospective enrollees. Assures that... ...reporting. Manages the preparation of all claims and invoices. Maintains referrals....ClaimsWork experience placementWork at officeLocal areaRemote work
Fallon Health
New Bedford, MA13 hours ago $18 per hour
...Mailroom Processing Clerk Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune... ...on Saturdays. Sort, prepare, and scan up to 2,000 insurance claims and related documents daily. Enter claim data into client...ClaimsHourly payMinimum wageFull timeFlexible hoursConduent
Springfield, MA3 days ago$51.81k - $83.55k
...The medical cost projection, also known as a Medicare Set-Aside (MSA) report, is part of a workers' compensation or liability claim settlement. The Medical Allocator will rely... ...unrelated to claim/s in settlement process Required to read extensively. Required...ClaimsMinimum wageLocal areaWork from homeCorVel
El Paso, TX1 day ago$186.2k - $363.09k
...and maintains the integrity of the appeals process, both internally and externally. •... ...improvement teams. • Facilitates conformance to Medicare, Medicaid, NCQA and other regulatory... .... • Conducts retrospective reviews of claims and appeals and resolves grievances related...ClaimsWork experience placementWork at officeLocal areaMolina Healthcare
Provo, UT3 days ago$221.3k - $420.5k
..., high-quality services to Medicaid and Medicare members, as well as to individuals and families... ...including committee structure, processes, and membership. Conduct regular rounds... ...utilization and health care quality. Reviews claims involving complex, controversial, or...ClaimsFull timePart timeWork at officeRemote workFlexible hoursWeekend workCentene Corporation
Baton Rouge, LA13 hours ago$19 - $21 per hour
...examinees, assists with directions, etc. Processes mail, deliveries and shipments as needed... ..., peer reviews, bill reviews, Medicare compliance, case management, record retrieval... ...insurance carriers, law firms, third-party claim administrators and government agencies...ClaimsHourly payFull timeWork at officeLocal areaImmediate startMonday to FridayExamWorks
Rancho Cordova, CA2 days ago$231.9k
..., high-quality services to Medicaid and Medicare members, as well as to individuals and families... ...including committee structure, processes, and membership. Conduct regular rounds... ...utilization and health care quality. Reviews claims involving complex, controversial, or...ClaimsFull timePart timeWork at officeRemote workFlexible hoursWeekend workCentene Corporation
Olympia, WA13 hours ago$117.49k - $149.8k
...for the position of Accounting Manager - Medicare/DSNP and Reg. Reporting in the range of... ...Drives continuous improvement in financial processes, systems, and the establishment of... ...those for incurred but not reported (IBNR) claims liabilities. ~ Provides leadership...ClaimsKHS
Bakersfield, CA2 days ago- ...Performs daily activities involved in the reimbursement process, i.e. claims filing/follow-up, entry of payments/adjustments, and follow-... ...external computer systems and payer portals, work traditional Medicare and Medicare Advantage/Replacement inventory to full resolution...ClaimsWork at officeLocal areaShift workDay shift
Southeast Alabama Medical Center
Dothan, AL2 days ago - ...Power of Every One. Job Title Research Medicare Coverage Analysis Specialist Location Cleveland... ...to achieving these goals, standardizing processes, and safeguarding Cleveland Clinic's... .... • Assist in the management of claims review by applying the appropriate CDM and...ClaimsWork at officeLocal areaRemote workShift work2 days per week3 days per week
$21 - $22 per hour
...sponsored health insurance programsincluding Medicare, Medicaid, and PACE (Program of All-... ...Additionally, supports the authorization process by receiving incoming faxed/mailed/emailed... ...member's medical services or the providers' claims. Interprets and triages information to...ClaimsHourly payContract workWork at officeLocal areaFallon Health
Worcester, MA3 days ago- ...receivable follow-up. ~ Demonstrates overall knowledge of claims processing for various insurances, including private and governed. ~... ...Stamford Hospital as a High-Performing Hospital. The Centers for Medicare and Medicaid Services (CMS) rated Stamford Hospital as a...ClaimsFull timeLive inWork at officeShift work
Stamford Health
Stamford, CT13 hours ago $60 per hour
...needs are met outside of operational hours -Processes prescriptions accurately and timely so... ...payers, specifically Medicaid and Medicare -Dispenses all medication pursuant to a... ...technicians in adjudication of pharmacy claims to ensure accurate payment is communicated...ClaimsBi-weekly payFull timeTemporary workShift workA-Line Staffing Solutions
Cary, NC13 hours ago- ...May support the NCQA Accreditation Program and oversight processes, CMS compliance, medicare part D& C audits and accreditation best practices and... ...REQUIREMENTS: Regulatory compliance CMS NCQA Claims EDUCATION/EXPERIENCE: High school graduate or equivalent...Claims
Imperial Health Plan of California, Inc.
Pasadena, CA4 days ago $100k - $120k
...health insurance products, including ACA, HIPAA, ERISA, and Medicare programs. Analyze how laws impact WPS Health Plan operations.... ...seniors and group health plans for small to large businesses. We process claims and provide customer support for beneficiaries of the...ClaimsFor contractorsLive inWork at officeLocal areaImmediate startRemote work2 days per weekWPS Health Solutions
Minneapolis, MN13 hours ago- ...encounter data submissions to CMS (Centers for Medicare & Medicaid Services). This role serves... ...ensuring our encounter data management processes meet regulatory and client standards.... .... Understanding of payer operations, claims processing, and encounter lifecycle...ClaimsRemote workFlexible hours
SafeRide Health
Houston, TX4 days ago $78.5k - $163.6k
...Data Analyst plays a key role within the Medicare Advantage Operations team, acting as a liaison... ...efforts related to software and process improvements. Gather and define business... ...Managed Care environment managing enrollment, claims or encounters required Minimum of five...ClaimsAcademy of Managed Care Pharmacy
Los Angeles, CA1 day ago- ...weekends and holidays possible during Annual Medicare Open Enrollment: 10/1 - 3/31 ~... ...eligibility, benefit coverage, authorizations, claims, and assisting them with locating a... ...knowledge of claim adjustments and resubmission processes to determine appropriate resolution to...ClaimsWork at officeRemote workMonday to FridayFlexible hoursShift workAfternoon shift
SKYGEN USA
Menomonee Falls, WI13 hours ago $21 per hour
...of the nation's leading not-for-profit Medicare Advantage plans, serving more than 277,0... ...member information. You Will Processes member applications by reviewing data for... ...correcting or updating data received on daily claims error report, unassigned PCP list and...ClaimsTemporary workFor contractorsRemote workScangroup
Long Beach, CA1 day ago- ...and execute data-driven analyses using claims databases and real-world evidence to... ...statistical analysis of U.S. commercial and Medicare claims data, real-world outcomes research... ...behalf (note: the government's licensing process can take 3 to 6+ months) or (ii)...ClaimsLocal areaWorldwideFlexible hours
Intuitive
Sunnyvale, CA4 days ago $67.1k - $102.46k
...Summary Performs clinical audit/validation processes to ensure that medical record... ...diagnosis coding for services rendered to Medicare Managed Care Product members is complete... ...Applies prospective and retrospective medical claims audit criteria, and conducts clinical...ClaimsFull timeWork at officeMonday to FridayShift workNight shiftWeekend workWeekday workPresbyterian Healthcare Services
Albuquerque, NM9 hours agonew
