- UpvoteDownvoteShare Job
- Suggest Revision
As part of this effort, Serco would execute the PERM review contract which includes collection of state eligibility policies and medical records; eligibility reviews, medical reviews, and data processing reviews, of selected state Medicaid and CHIP fee-for-services (FFS) and managed care claims; and supporting state and national reporting of payment error rate and development of corrective actions based on findings.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Advise on managed care claims, third-party liability, Medicaid waiver programs, and provider enrollment. Extensive knowledge and practical experience in managed care claims, third-party liability, Medicaid waiver programs, and provider enrollment.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Identify the managed care operations you have managed in a Knox Keene licensed health plan and the associated regulatory requirements, as applicable (i.e., Contracting, (Ancillary, Facility, Fee-for-service, Professional, Risk Based), Contract and Benefits Configuration, Compliance, Disputes and Grievances, Credentialing, Claims, Provider Data Management, Provider Relations, Service Operations, or Provider Services.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Partner with Billing Specialists to ensure accurate processing and billing of Medicare, Medicaid, Managed Care, Worker's Compensation, other government programs, motor vehicle, personal injury and protections, third party payer experience, self-payer/uninsured and commercial insurance processing patient claims in accordance with payer requirements and organization policy.
Full-timeRemoteExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Knowledge and experience with Medicaid, managed care, MMIS, health claims payment and processing, population health management, or other similar areas. Knowledge and experience with Medicaid, managed care, MMIS, health claims payment and processing, population health management, or other similar areas.
ExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
Knowledge and experience with Medicaid, managed care, MMIS, health claims payment and processing, population health management, or other similar areas | Highly desired. Job Title- Test Lead Engineer Location- 2MLK Jr Dr, SE West Tower - 16th Floor (Hybrid) The Georgia Department of Community Health (DCH) is in the process of transforming existing legacy Medicaid Enterprise Systems (MES) into modern, loosely coupled, seamlessly integrated, modular systems where the exchange of data and processes is seamless and automatic.
$80 - $100 an hourExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
The Georgia Department of Community Health (DCH) is in the process of transforming existing legacy Medicaid Enterprise Systems (MES) into modern, loosely coupled, seamlessly integrated, modular systems where the exchange of data and processes is seamless and automatic.
ExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Minimum Required Education, Experience & Skills High School graduate with three years of experience where the primary responsibility was in any one of the following categories: health care, economic services, counseling, sales, medical billing, or processing insurance claims.
Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Supports Treatment Services' billing & data needs through the input, extraction of data, pre-authorization and reauthorization reviews; processing of invoices and claims in a managed care environment.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Three years’ experience and knowledge of HMO, PPO, TPA, PHO and Managed Care functions (e.g. accounting/finance, reinsurance, EDI, marketing, administration, medical delivery, regulatory compliance, claims processing, membership/eligibility, contracting and risk arrangements and actuarial precepts.
RemoteExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
We are looking for a motivated performer to join our Camp Lowell Surgery Center-Business Office team as a Collections Specialist, with an extensive knowledge of claims reimbursement and collection efforts for Managed Care, Medicare, Medicaid, Workers Comp, Commercial plans, etc.
Full-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
Ability to obtain the clinical documentation necessary for claims processing, i.e. x-rays, chart notes and letters of necessity; investigating certain denied claims, following-up on those investigations and submitting claims appeals for those denied claims.
TemporaryExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Strong knowledge of medical insurance billing and collections with CPT, ICD9, and HCPC coding and medical terminology, as well as an overall understanding of managed care products (HMO, PPO, etc.
Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
This will involve providing quality control checks on paper claims; processing tracers, denials and related correspondence; initiating appeals; and drafting, composing, and submitting appeal letters.
$26.85 - $35.41 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
High school diploma or Associate degree in Accounting or Business Administration or related field, and a minimum of four (4) years' experience within a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting or customer service activities or an equivalent combination of education and experience.
ExpandApply NowActive JobUpdated 2 days ago
claims processing managed care jobs
FEATURED BLOG POSTS
How To Answer “Why Do You Want to Be a Supervisor” in an Interview
Anyone who has worked in a supervisor role knows how challenging yet rewarding it is. But chances are if you're trying to become a supervisor, you'll be forced to answer:
What is Career Cushioning?
Is your organization prepared for “career cushioning”?
Growing Discontent: Employees Wouldn't Wish Their Jobs on Their Worst Enemy
The start of a new year, and most people are already busy setting personal and professional goals. What’s on the top of the list for a growing number of working people is making an exit from the job they currently have. Why?
How to Gracefully Quit a Job You Just Started
You’ve just started learning the ropes at your new job, and you've gotten to know your colleagues. But you’re already thinking about quitting. Maybe you were deciding between to job offers and realized that you’ve made the wrong choice. Or, a change in your personal circumstances means that you have to quit.
How to Professionally Reschedule a Job Interview Without Destroying Your Chances
You’ve practiced answering common interview questions and refined your “greatest weakness.’ Nothing can stop you until BAM! The flu hits your household. Or you ran over a nail and popped a tire en route to the interview. When you need to pivot, there’s a good, better, and best way to reschedule a job interview. Here’s how to do it professionally, so you can nail the gig when the timing is right.
What is a W-9 and How to Fill One Out
When you began working for yourself, you probably didn’t account for the tax reporting work that will fall on your shoulders each year. If you’re a freelancer, independent contractor, or business owner, filing your taxes is not as simple as uploading your W-2 form into some online tax preparation software. Most self-employed people need to complete a W-9 as a step for accurately reporting their earnings to the IRS. Below, you can learn how to fill out a W-9 and when to submit it.
A Comprehensive Guide to Becoming a Better Conversationalist
Have you ever stood awkwardly next to someone at a party because you didn’t know what to say to them? How about at a networking event or on a first date? You're not alone if you’ve ever experienced this uncomfortable silence. Many people struggle to master the art of being a great conversationalist.