Manager, Medicare Claims - Arizona

We are looking for a Manager to oversee end-to-end claims services for provider segments. · Streamline shared processing to reduce management by exception · Set operational processes to align with market trends and customer demand · Manage accounting and financial reporting funct ...

++Provides support for claims activities including reviewing and resolving member and provider complaints. · Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members--> · Researches claims appeals and grievances usi ...

Provides lead level support for claims activities including reviewing and resolving member and provider complaints, · and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare an ...

The Billing Specialist I plays a key role in Spectrum's revenue cycle operations by ensuring timely and accurate billing, · financial reporting, and payment posting.Prepare and submit accurate claims to Medicaid,Medicare,and Commercial payers. · Post payments,denials,and daily de ...

The Provider Contract Manager serves as the expert for provider contract language, · ensuring contracts are compliant, scalable, · and operationally executable across a rapidly growing, · value-based primary care organization.Bachelor's degree in Business, · Healthcare Administra ...

A Clinical Review Clinician - Appeals works with authorization and claims review requests nationwide. · ...

Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied. · ...

Remote Clinical Review Appeal Nurse opportunity in Arizona. · ...

The RN Clinical Appeals Nurse provides support for internal appeals clinical processes ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements Molina policies and procedures and medically appropriate clinical guideline ...

The Claims Examiner II is an intermediate level position responsible for the timely review and adjudication of all types of Medicaid claims. · Adjudicate medical claims in accordance with plan provisions, state and federal regulations. · ...

We have an exciting opportunity for a fully remote Workers' Compensation Claims Adjuster Senior. The ideal candidate must possess Arizona jurisdiction technical claims knowledge. Additional experience in MO, KS, CO, UT, NM, NV and/or TX jurisdictions is preferred. · The Workers' ...

We are seeking an experienced Mental Health Biller to join our revenue cycle team. · Submit insurance claims (primary and secondary) accurately and in a timely mannerReview and resolve rejected/denied claimsManage aging reports and follow up on unpaid claimsVerify insurance eligi ...

This Medical Billing Representative will provide revenue cycle process including charge capture, claim submission, payment posting, claim follow up and appeals to ensure efficient timely and accurate payment of accounts for Physical Therapy Practices. · ...

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Data Analyst - REMOTE. · You will contribute to the analysis and interpretation of complex healthcare data to support key government programs. · ...

Responsible for all or part of the following: billing and collecting, research, correspondence, payment and adjustment posting. · ...

Provides senior level analyst support for medical economics analysis activities. · ...

Leads and supervises team responsible for enterprise network management and operations activities including network development, network adequacy, and provider training and education. Serves as primary point of contact between the business and contracted providers within the Moli ...

This Senior Medicare Network Manager role involves developing and maintaining specialized networks tailored to Medicare Advantage populations. Ensuring operational standards and vendor satisfaction are key responsibilities. · Work with Transportation Providers. · C_ordinate month ...

We are searching for a dynamic person to join our team as a Provider Enrollment Specialist. · ...

You could be the one who changes everything for our 28 million members. · ...