- UpvoteDownvoteShare Job
- Suggest Revision
Manipulates and extracts Medicare, Medicaid, and other healthcare claims data stored in Cloud environment using appropriate software such as SAS, Snowflake, Python, R, SQL, and other software as appropriate for the task.
RemoteExpandUpdated 5 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Work you’ll doProvide expertise on Medicare (preferably Claims) Healthcare AnalyticsDevelop healthcare data analysis visualizations and support data linkages to those visualizationsPerform data modeling, database development and managementDevelop user stories and mockups for data visualizationPerform coding and testing of data visualizations using open source or visualization packages such as Tableau.
Full-timeExpandUpdated 6 days ago - UpvoteDownvoteShare Job
- Suggest Revision
The Deputy Chief Operating Officer (DCOO) is a member of MetroPlusHealth’s Senior Management team and is vital in providing assistance with the oversight, management, and supervision of Operations, in a matrix organizational structure including: PMO, Process Improvement, Provider Network Operations, Call Center, Credentialing, Facilities, Enrollment & Membership, Vendor Management, Customer Success, and Claims.
$260,000 - $287,000 a yearFull-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
- Suggest Revision
Under the supervision of the Revenue Cycle Manager, this position is responsible for the timely and accurate billing of commercial/group insurance/Medicare/Medi-Cal/managed care and self-pay home health/hospice accounts, posting of payments/remittance advices, review of unpaid claims/patient accounts and use procedural guidelines to reduce the outstanding dollars on accounts receivable.
$21.5 - $35.46 an hourFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
Analyze the impact and application of federal and state health care laws and regulations, including Anti-Kickback statute, Stark law, False Claims Act, HIPAA, fraud and abuse laws, the Affordable Care Act, and Medicare related regulations in relation to the clinical, strategic, and business operations of the Company.
ExpandUpdated 5 days ago - UpvoteDownvoteShare Job
- Suggest Revision
We are an award-winning, not-for-profit health maintenance organization offering Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members.
ExpandUpdated 5 days ago - UpvoteDownvoteShare Job
- Suggest Revision
7+ years working in risk adjustment leadership roles in a Medicare Advantage environment with detailed knowledge of the CMS RAF model as well as experience working with healthcare data, specifically medical claims and/or encounter data.
ExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Responsible for Claims Department and Provider Services Department compliance with all Medicare and Medi-Cal regulatory requirements. Participates in all Claims Department and Provider Disputes compliance audits, such as Medicare Finance audit, DMHC claims audit, CMS data validation audit, etc.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Coding and submitting claims to payers and government programs, such as Medicare and Medicaid. Working with payers to resolve claims that are denied or underpaid. Must be able to multi-task and handle competing priorities while meeting or exceeding deadlines is often required, along with certification in medical coding and/or revenue cycle management.
ExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
Providing sound, practical judgment in the interpretation and application of relevant laws and regulations, including the Anti-Kickback Statute, the Beneficiary Inducement Statute, Medicare/Medicaid, False Claims Act, Stark Law, HIPAA and state health information privacy laws, and marketing and advertising laws applicable to the marketing and promotion of medical products.
ExpandUpdated 5 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills.
ExpandUpdated 5 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Verifying daily Census Verify all billing and financial data for new admissions Medicare A & B Billing, Claims Corrections and Follow-up Managed Care , Claims Corrections and Follow-up Private Pay Billing and Collections.
Full-timeExpandApply NowActive JobUpdated 16 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Substantive experience with federal criminal practice or government investigations, including matters related to the False Claims Act, Anti-kickback statute, Medicare and Medicaid compliance, OIG/DOJ investigations, and healthcare fraud, is advantageous for this role.
ExpandUpdated 5 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Health Plan (claims, membership, medicare) JIRA, Confluence, RTC. Perfict Global is a leading IT consulting services provider focused on providing innovative and successful business workforce solutions to Fortune 500 companies.
ExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Assists pharmacy team with all management of electronically adjudicated claims to ensure all prescription delivery assessments are reconciled and copay payments are charged prior to shipment. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections.
ExpandUpdated 5 days ago
medicare claims jobs
FEATURED BLOG POSTS
Resume Job Description Samples - 8 Tips to Follow
When looking for a job, your resume becomes a crucial element. From making a great first impression to showcasing all your achievements and potential, your resume has to portray your professional story in minutes.
Internship Cover Letter Tips with Examples
Until now, college has been about learning, absorbing, and experiencing. It’s not until you become eligible for an internship that things start getting real—real-world experiences using real-life scenarios. Applying for internships takes time, and there’s no college course on “how to apply for jobs.” (We’d sign up immediately if there was, though!) But here's a spoiler alert: most internships require a cover letter. And while this may seem like a burden, it’s actually a blessing.
5 Practical Ways to Remove Bias from your Hiring Process
Many employers think their hiring process is perfect. However, research shows that the hiring processes are generally impartial and unfair, especially if you are part of certain demographics. Women, people of color, people with disabilities, or even people in lower socioeconomic status are more likely to be subject to implicit bias. As diversity and employer branding become major aspects of business, it is important that employers take the lead to identify and remove bias from the hiring process. So, here are 5 practical ways to get you started.
Tips to Get Your First Job Confidently
Whether you’re a recent graduate or you still have a few exams left, you may be itching to put your polished leather shoes on and join the workforce. After all, your first job is an entryway into the professional life you’d lead for the decades to come.
Tips for a Good Character Reference Letter with Examples
Hiring managers love a resume laden with relevant skills and qualifications. Hard skills specific to the role, like SEO strategy or Java programming languages, are easy to qualify using achievements or facts and figures. But how exactly can they verify personality traits, work ethic, relationship management skills, or curious nature during an interview when they barely know you?
How to Dress on the First Day of Work (Men & Women)
You did it! Out of hundreds of applicants and dozens of people interviewed, you’re the one who got a new job. Congrats! Now comes the question of how to dress on the first day of work.
Why College Students Should Work While in College?
College is a special part of our lives. It’s a time when we prepare for our dream job while creating some of the most memorable moments in life. That said, college life can also be stressful. Not only do we have to spend long hours studying, writing and researching, but we also have to deal with increased tuition fees and living expenses.