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$20.72 per hour
...(Automated Inline Mailing Systems) for processing of automated mail. This role is a 2nd shift... ..., veterans, Guard and Reserves and Medicare beneficiaries Working in a continuous... ...for small to large businesses. We process claims and provide customer support for beneficiaries...ClaimsContract workFor contractorsSecond jobLocal areaImmediate startMonday to FridayShift workAfternoon shiftWPS Health Solutions
Madison, WI4 hours agonew$39k - $49.4k
...Claims Processing Representative Become a part of our caring community and help us put health first. The Claims Processing Representative... ...processing experience CIS pro and CIS experience Medicare experience CMS experience Additional information - how...ClaimsBi-weekly payFull timeTemporary workWork at officeRemote workWork from homeHome officeDenver Staffing
Denver, CO2 days ago- ...organization. Position Overview Job Summary: Processes and ensures the accuracy and timely... ...care professionals with assistance with Medicare, Medicaid, Prescription Drug Plans (PDPs... ...Responsibilities Generate and submit claims to insurance providers. Verify the...ClaimsLocal areaHome office
Trilogy Healthcare Services
Louisville, KY4 days ago - ...Medicare Claims & Appeals Specialist Overview: Seeking an experienced Medicare Claims professional with strong exposure to the grievance and appeals process . This role is highly case-driven, with daily work varying by claim type and complexity. The ideal candidate...Claims
TEK Connexion
Durham, NC3 days ago $69.7k
...clinical finances related to state Medicaid/Medicare programs, including MassHealth and other... ...incumbent will assist the Billing and Claims Manager with effectively managing the... ...Medicaid programs. This position requires processing of claims and pre-authorizations on a...ClaimsFull timeFor contractorsWork at officeBoston Staffing
Boston, MA1 day ago- ...attorneys, brokers, medical providers, and Medicare to create a seamless experience for our... ...the way funds from insurance claim settlements are administered after settlement... ...Maintain the expected turnaround time for processing receipts. Performing other clerical tasks...ClaimsHourly pay
Ametros
Wilmington, MA4 days ago $154.13k - $254.3k
...A prominent health plan provider is seeking a Director of Claims to oversee the direction and management of medical claims processing while ensuring compliance with regulatory standards. The ideal candidate will have at least five years of healthcare administration experience...ClaimsFull timeASSOCIATION FOR COMMUNITY AFFILIATED PLANS
Washington DC4 days ago$154.13k - $254.3k
...health plans and the largest not-for-profit Medicare-Medicaid plan in the country. In its 29... ...: Reporting to the Senior Director, Claims, the Director, Claims is responsible for... ...and oversight of all medical claims processing, provider disputes & appeals, quality assurance...ClaimsFull timeASSOCIATION FOR COMMUNITY AFFILIATED PLANS
Washington DC4 days ago- ...Accounts Representative - Medicare Biller Job Category: Clerical/Admin Requisition Number: ACCOU001868... ...Hours of Job Duties and Key Responsibilities Processes and follows up on all Medicare claims until proper reimbursement is received. Works denials...ClaimsFull timeLocal area
Joint Township District Memorial Hospital
Ohio2 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
Pensacola, FL21 hours ago$70k - $80k
...Auditor conducts hospital charge audits on claims paid at percent of billed charges to... ...to payer policy, industry standards and Medicare Guidelines. The nurse will also be responsible... .... Report any problems in the audit process to Manager for resolution. Comply with...ClaimsContract workEXL
Washington DC4 days ago- ...multilingual are strongly encouraged to apply. Medicare Billing Requirement Candidates must be... ...to complete the Medicare enrollment process. Responsibilities Provide direct... ...personnel to ensure authorizations and claims are processed appropriately Provide...ClaimsExtra income
Making Opportunity Count Inc
Fitchburg, MA21 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 - ...Stamford, CT, is seeking a full time SNF Medicare Biller for our Boutique Skilled Nursing neighborhood... ..., Word, and Outlook. Proficiency with claims management software systems.... ...reimbursement methods, and the claims appeal process. ~ Knowledge of and ability to follow...ClaimsFull timeWork at office
Benchmark Senior Living Nashua Crossings
Stamford, CT4 days ago - ...6% of hospitals rated by the Centers for Medicare and Medicaid Services. We believe that our... ...rejected, incorrectly paid and denied claims as requested./liliHelps to maintain a professional... ...informed of changes in authorization process, insurance policies, billing requirements...Claims
Wyoming Staffing
Sheridan, WY1 day ago - ...supervision, the Government Collector resolves unpaid Medicare accounts, submits adjusted claims as needed for overpayments and completes compliance projects... ...40 Work Shift Job Description Prepares and processes payments for vendor invoices and other financial...ClaimsHourly payFull timeWork experience placementRemote workShift work
Medical University of South Carolina
Charleston, SC1 day ago - ...someone to start ASAP Key technologies: Medicare Medical Necessity Appeals and... ...Appeals and Grievances Area Nice to haves: Claims knowledge or experience. Know salesforce... ...Health Plan operations and business unit processes, workflows and system requirements, including...ClaimsFull timeWork at officeImmediate startRemote work
Spectraforce Technologies
Phoenix, AZ1 day ago - ..., but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus... ...Facilitate the integration of contract payment terms into the claims processing system and comprehensively understand the downstream impact...ClaimsContract workShift work
MetroPlusHealth
New York, NY1 day ago - ...applicable lines of business, including Medicare Advantage, Marketplace, and Commercial products... ...pharmacy, quality improvement, claims, and network management, to support coordinated... ...care utilization management and appeals processes preferred. Ability to work...Claims
CommunityCare
Tulsa, OK2 days ago $19.49 per hour
...care agencies, DME suppliers) regarding claim decision and payments across all Centers... ...evaluate and identify opportunities to drive process improvements that positively impact... ...Care Organization servicing members with Medicare and/or Medicaid. Our goal is to provide members...ClaimsHourly payCenters Plan for Healthy Living
Staten Island, NY2 days 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
Albany, NY4 days ago- ...Mass Advantage is a Medicare Advantage health plan, located in the heart of Worcester County... ...seamless integration and performance of claims, enrollment, customer service, and... ...will lead cross-functional teams, optimize processes, and deliver operational excellence to support...Claims
Central Mass Health LLC
Worcester, MA4 days ago $35.04k - $43.8k
...opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans,... ...update requests and demographic-related claim denial inquiries are handled appropriately... ...non-par providers, under the file update process, for the Data Maintenance Team, as needed...ClaimsFull timePart timeWork at officeFlexible hoursMJHS
New York, NY2 days ago$21 per hour
...a Customer Service Representative at Medicare Joe , youll be the first point of contact... ...our mission is to simplify the Medicare process and serve every client with clarity, compassion... ...and resolving escalated issues Handle claim and carrier concerns with efficiency and...ClaimsHourly payFull timeTraineeshipWork at officeMedicare Joe
Smithfield, RI4 days ago$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$186.2k - $363.09k
...Job Summary As a Medical Director for Medicare Programs, you will provide essential... ...the integrity and operation of the appeals process, both internally and externally. Investigate... .... Conduct retrospective reviews of claims and appeals, resolving grievances...ClaimsWork experience placementWork at officeLocal areaMolina Healthcare
Miami, FL4 hours agonew$210.8k - $400.5k
..., high-quality services to Medicaid and Medicare members, as well as to individuals and families... ...including committee structure, processes, and membership. Utilizes the services of... ...utilization and/or health care quality. Reviews claims involving complex, controversial, or...ClaimsFull timePart timeWork at officeRemote workFlexible hoursCentene Corporation
Raleigh, NC4 days ago$65.6k - $103.32k
...Clinical Review Nurse I - Medicare Part A This role enables associates to work virtually... ...making medical determinations as to whether a claim meets the benefits the member carries.... ...will be discussed as part of the hiring process. The health of our associates and...ClaimsFull timeWork at officeLocal areaMonday to Friday1 day per weekOhio Staffing
New York, NY2 days ago- ...job is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides... ...hands-on assistance services (i.e., chart reviews, mass claims adjustments, UDC processes, etc.) to PCPs enrolled in Medicare STARS, Medicaid...ClaimsWork at office
Highmark Health
Pittsburgh, PA1 day ago - ...analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, workers... ...Familiarity with both UB-04 and CMS 1500 claims data, as well as understanding of payor... ...HIPAA, data privacy, and/or data security processes. Experience working with regulators...ClaimsWork at officeLocal areaRemote work
Marwood
Long Island City, NY1 day ago
