7 Medicaid Regulations Jobs

Role Overview: As a Billing Specialist (Cardiology) at our company, you will be responsible for accurately processing cardiology-related claims, verifying insurance eligibility, maintaining compliance with billing regulations, collaborating with stakeholders, utilizing EHR/EMR systems, and monitoring accounts receivable reports in a fast-paced cardiology practice setting. Key Responsibilities: - Accurately process cardiology-related claims (CPT, ICD-10, HCPCS codes) and ensure timely submission to insurance providers. - Verify insurance eligibility, authorizations, and pre-certifications for cardiology procedures. - Maintain compliance with HIPAA, Medicare, Medicaid, and private insurance bi...

Role Overview: You will be responsible for reviewing provider disputes related to DRG Coding and Clinical Validation, Itemized Bill Review, and Clinical Chart Review. Your main tasks will include analyzing disputes, providing explanations based on findings, managing claim dispute volume, and ensuring adherence to client turnaround times and department procedures. Additionally, you will serve as a subject matter expert for the Expert Claim Review Team, creating educational materials, conducting research, and maintaining bill review content. Key Responsibilities: - Review provider disputes for DRG Coding and Clinical Validation, Itemized Bill Review, and Clinical Chart Review - Submit explanat...

As an Operations Manager, you will be responsible for supporting a growing client base and managing the day-to-day operational activities of the production team. Your role will involve coordinating with both internal and external teams to ensure the team delivers projects as per set expectations while maintaining the required quality standards. **Key Responsibilities:** - Supervise the day-to-day operations and effectively manage a team of production analysts/Team Leads on the assigned project. - Ensure the team delivers 100% on projects within the contracted turn-around-time and meets accuracy metrics as per client SLA. - Optimize staff utilization and manage shrinkage to meet daily deliver...

As a candidate for this role, you should be prepared to join immediately and can share your details via email at nitin.patil@ust.com for quick processing. Role Overview: You will be responsible for identifying and driving strategic value creation opportunities across operations and financial functions. Your role will involve providing consulting advisory services in operating model design, performance improvement, change management, and technology enablement. Additionally, you will lead the creation of project plans, manage budgets, timelines, and resource allocations. Collaboration with internal sales and delivery teams to define go-to-market strategies and win new business will also be a k...

You are an experienced Billing Specialist (Cardiology) with a minimum of 5 years of expertise in cardiology billing. You possess a deep understanding of medical billing, coding, insurance claims, and revenue cycle management specific to cardiology. Your role involves accurately processing cardiology-related claims (CPT, ICD-10, HCPCS codes), verifying insurance eligibility, and ensuring timely submission to insurance providers. You must maintain compliance with HIPAA, Medicare, Medicaid, and private insurance billing regulations while collaborating with physicians, administrative staff, and insurance providers to resolve billing discrepancies. Utilization of EHR/EMR systems (e.g., Epic, Athe...

As a Provider Dispute Specialist at our organization, you will play a crucial role in reviewing provider disputes related to DRG Coding and Clinical Validation, Itemized Bill Review, and Clinical Chart Review. Your responsibilities will include submitting explanations of dispute rationale back to providers within the designated timeframe to ensure client turnaround times are met. You will be accountable for managing claim dispute volume on a daily basis, adhering to client turnaround time, and department Standard Operating Procedures. In this role, you will serve as a subject matter expert for the Expert Claim Review Team, providing support on day-to-day activities, troubleshooting, and ensu...

The ideal candidate for this role should be ready to join immediately and can share their details via email for quick processing. Please send your information to nitin.patil@ust.com to receive immediate attention. Roles & Responsibilities: - Identify and drive strategic value creation opportunities across operations and financial functions. - Provide consulting advisory services in operating model design, performance improvement, change management, and technology enablement. - Lead the creation of project plans, manage budgets, timelines, and resource allocations. - Collaborate with internal sales and delivery teams to define go-to-market strategies and win new business. - Build client relat...