294 Medicaid Jobs - Page 11

Role Title: IT Project Management Senior Analyst - Integrated Solution Manager Position Summary: The Integrated Solution Manager Senior Analyst is responsible for defining and supporting the building of the integrated test strategies and test plans those alignments with the portfolio and program epic needs over the product lifecycle. This individual will work with business, technology, and solution teams to develop artifacts that supports the program overall long-term business objective. This individual must possess a strong understanding of Cigna processes and capabilities across all integrated application/business work streams. & Responsibilities : The ISM drives the testing phases and del...

Role TitleIT Project Management Advisor - Integrated Solution Manager Position Summary: The Integrated Solutions Manager Advisor will work with business, technology, and solution teams to develop artifacts that support the program’s overall long-term business objectives. This individual must possess a strong understanding of Cigna processes and capabilities across all integrated application/business work streams. & Responsibilities: Provides counsel and advice to top management on significant Integrated Solution matters, often requiring coordination between organizations. Responsible for managing, directing, and planning multiple complex projects, or occasionally one highly complex project, ...

Job Summary We are seeking a dedicated Senior Process Executive - HC with 1 to 3 years of experience in Claims Adjudication. The ideal candidate will have expertise in Medicare and Medicaid Claims and it is advantageous if they also have experience in Commercial Claims. This is a work-from-home position with night shifts. Responsibilities Process and adjudicate Medicare and Medicaid claims efficiently and accurately. Ensure compliance with all relevant regulations and guidelines. Analyze and resolve claim discrepancies and issues promptly. Collaborate with team members to improve claim processing workflows. Maintain up-to-date knowledge of industry standards and changes. Provide exceptional ...

Immediate Requirement Hospital Billing AR Caller / Sr. AR Caller Exp: 1 to 7yrs Salary: 42k Location: Bangalore Interested Candidate Plz Drop Updated CV to gayathri.srinivasan@geniehr.com or Ping me 7339094334

BA SQL Medicaid US Healthcare, Medicaid, Claims, SQL, QNXT, Facets Gather and analyze business requirements from stakeholders Document BRDs, FRDs, and user stories for development teams Facilitate communication between business and technical teams Conduct gap analysis and suggest improvements Support UAT, training, and deployment activities Create process flowcharts, data models, and presentations Track project progress and provide status updates to leadership

Role & responsibilities Accurately post all payments (electronic, checks, credit cards, etc.) to patient accounts in the billing system. Ensure all payments are applied to the correct accounts and invoices. Identify and resolve discrepancies between posted payments and actual deposits. Post adjustments, write-offs, and denials as per payer contracts and company policies. Identify trends in denials and underpayments and communicate findings to management. Identify billing errors and make necessary corrections to avoid claim denials. Ensure timely and accurate submission of claims to payers. Manage the resolution of denied claims by identifying root causes and correcting errors. Resubmit corre...

Job Summary We are seeking an experienced Architect with 12 to 15 years of experience to join our team. The ideal candidate will have strong technical skills in React JS and Java along with domain expertise in Medicare and Medicaid Claims Claims and Payer. This hybrid role requires a proactive individual who can drive technical solutions and contribute to the companys mission of improving healthcare systems. Responsibilities Lead the design and development of scalable and efficient software solutions using React JS and Java Oversee the implementation of technical solutions that align with business requirements and industry standards Provide technical guidance and mentorship to the developmen...

Job Location : Hyderabad Qualification - Graduate Work mode Work from office Shift timing 1:00 PM IST to 12:00 AM IST Team leader - 12 lpa Team Manager - 15 lpa Notice 0-60 days US Health Care Domain Knowledge. E.g. Encounters, EDI, HIPAA, 837 Layout, insights into Medicare and Medicaid Markets etc. Facets or any other healthcare adjudication system knowledge will be added advantage. SQL Server SSIS and SSRS plus any Microsoft cloud technologies will be added advantage. Analytical and Query Writing Skills(SQL) SQL Procedure and Packages Debugging skills. Knowledge on any reporting tools or software e.g. Tableau or Power BI etc. PPT Presentations with client. Should be good at communication s...

Roles & Responsibilities: Follow up with the payer to check on claim status. Identify denial reason and work on resolution. Save claim from getting written off by timely following up. Should have sound knowledge of working on Billing scrubbers and making edits. Work on Contractual adjustments & write off projects. Should have good Cash collected/Resolution Rate. Should have calling skills, probing skills and denials understanding. Work in all shifts on a rotational basis. No Planned leaves for next 6 months Requirements: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (bo...

Essential Duties and Responsibilities: Must be on current role of team handling for minimum 1.5 years Great knowledge AR/Credit up or end-to-end knowledge Should be aware of all type of payers. Must have good understanding of payer portal for benefits & denials. Should have great verbal and written communication skills, probing skills and denials understanding Open for night shift and WFO No Planned leaves for next 6 months. Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal) . Skill Set: Candidate should be good Healthcare knowledge. C...

Roles & Responsibilities: Follow up with the payer to check on claim status. Identify denial reason and work on resolution. Save claim from getting written off by timely following up. Should have sound knowledge of working on Billing scrubbers and making edits. Work on Contractual adjustments & write off projects. Should have good Cash collected/Resolution Rate. Should have calling skills, probing skills and denials understanding. Work in all shifts on a rotational basis. No Planned leaves for next 6 months Requirements: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (bo...

Role Objective : Authorization Creation is a process where we need to coordinate with the nurses for decrypting the medical records & reports. Essential Duties and Responsibilities Interact with the US health insurance companies (Insurance Customer Care/Nurses/UM Team) Quality of Notation, Ability to read clinical documentation and data enter for payer requirements. 80%+ Calling will be involved (may vary site to site), should be open to Voice based work Would secure relevant information of Health Insurance of the patient. Work on Websites/Applications to perform the activity as per the SOP. Would be working in 6pm to 3 am & 9pm to 6am, Supporting US operations (in EST Zone) Should be Open t...

Role Objective Follow up is the most essential part in the RCM cycle. It is usually the last step in the cycle after cashposting. After Denial management (AR Follow up), again the cycle starts till the payment is made by the insurance company. Essential Duties and Responsibilities: Establishes and assures compliance with departmental policies and procedures in conformance with corporate policies and procedures. Manages people and drives retention Analysis data to identify process gaps, prepare reports Performance management First level of escalation Work in all shifts on a rotational basis Need to be cost efficient with regards to processes, resource utilization and overall constant cost man...

Role Objective: To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers. Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal) Skill Set: Candidate should have good healthcare knowledge. Candidate should hav...

Role Objective: To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers. Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal) Skill Set: Candidate should have good healthcare knowledge. Candidate should hav...

Role Objective: To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers. Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal) Skill Set: Candidate should have good healthcare knowledge. Candidate should hav...

Role Objective: To bill out medical accounts with accuracy within defined timelines and reduce rejections for payers. Essential Duties and Responsibilities: Process Accounts accurately basis US medical billing within defined TAT Able to process payer rejection with accuracy within defined TAT. 24*7 Environment, Open for night shifts Good analytical skills and proficiency with MS Word, Excel, and PowerPoint Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal)Skill Set: Candidate should have good healthcare knowledge. Candidate should have...

Responsibilities: * Manage denials through effective communication with providers and insurers. * Ensure compliance with HIPAA, Medicaid, Medicare, Cobra, ICD, CPT, HCPCS codes. Health insurance Office cab/shuttle Provident fund

Job Description The Provider Enrollment is responsible for the timely and accurate enrollment of healthcare providers with government and commercial insurance payers. This role ensures that providers are enrolled correctly and efficiently so that they can bill and receive reimbursement for services renders. The Specialist works closely with the Hospital system and payer organizations to facilitate smooth onboarding and maintain compliance with payer requirements. Role & responsibilities Prepare, submit, and track provider applications for enrollment and credentialing with Medicare, Medicaid, and commercial payers. Assist with creating and maintenance of CAQH profiles. Monitor and follow up o...

#FOLLOW-UP WITH MEDICAL INSURANCE PAYERS REGARDING THE STATUS OF OUTSTANDING CLAIMS #PROFICIENT IN COMPLETING AND SENDING CLAIM FORMS ACCORDING TO UB04,CMS& THIRD-PARTY PAYER GUIDELINES #STRONG KNOWLEDGE OF END TO END DENIAL MANAGEMENT PROCESSES Required Candidate profile 1 TO 4 YEARS EXP. AR CALLING PROCESS(CMS1500)EXP. IN COMP. & SUB. CLAIM FORMS ACC. TO CMS & THIRD-PARTY PAYER GUIDELINES STRONG FOCUS ON SERVICE EXCELL. WHEN DEALING WITH PATIENTS,CLIENTS & COMP. EMP. Perks and benefits #BEST SALARY, INCENTIVE PLANS #VIRTUAL INTERVIEWS

Role & responsibilities Allocates and delegates takes amongst employees. Provides operational support to employees on all phases of transaction processing. Interacts with clients and internal departments to solve issues. Identifies and resolves issues around pending transactions. Performs quality audit on accounts . Preferred candidate profile Skills Required 3-5 years of experience in claims adjudictaion. Demonstrated client interaction skills. Ability to analyze reasons behind incomplete transactions. Understands process interdependencies • Possesses deep domain knowledge in Healthcare and Insurance domain Interested please share your resume to pushpa.shanmugam@nttdata.com

R1 RCM India is proud to be recognized amongst India's Top 50 Best Companies to Work Fo2023 by Great Place To Work Institute. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to make healthcare simpler and enable efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 14,000 strong in India with offices in Delhi NCR, Hyderabad, Bangalore, and Chennai. Our inclusive culture ensures that every employee feels valued, respected, and appreciated with a robust set of employee benefits and engagement activities. Responsibilities: Follow up with the payer to check ...

Job description R1 RCM India is proud to be recognized amongst India's Top 50 Best Companies to Work Fo2023 by Great Place To Work Institute. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to make healthcare simpler and enable efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 14,000 strong in India with offices in Delhi NCR, Hyderabad, Bangalore, and Chennai. Our inclusive culture ensures that every employee feels valued, respected, and appreciated with a robust set of employee benefits and engagement activities. Responsibilities: Follow up with the...

Hiring for US Healthcare company Grad with 7 months exp in RCM can apply UG/Btech with 12 months RCM can also apply Salary upto 3.60 LPA to 5.50 LPA Fixed Sat-Sun off Fixed nght shifts Loc- Gurgaon / Noida Snehal@9625998099 Required Candidate profile Candidate should have good knowledge on RCM. Candidate should be comfortable with night shifts. Candidate should have decent typing speed. Perks and benefits Both side cabs One time meal

1. AR Calling (US Healthcare) Physician Billing || Upto 40k TH || Eligibility :- Min 1+ years of experience into AR Calling into physician billing Locations :- Hyderabad , Chennai, Noida & Mumbai Package :- Upto 40k take home Qualification :- Any UG / Graduate Immediate Joiners to 1 month notice is acceptable WFO. Hospital Billing || Upto 55k TH || Eligibility :- Min 1+ years of experience into AR Calling into physician billing Locations :- Hyderabad , Bangalore Package :- Upto 55k take home Qualification :- Inter & above Immediate Joiners Preferred WFO. 2. IV Calling & Prior Authorization (RCM) || 32k TH || Experience :- Min 1 year in IV Caller (or) Prior Authorization Location :- Chennai P...