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Medicare Remote Jobs

479 fresh jobs found

Healthplan Informatics Manager - Remote Eligible
Albuquerque, NM, United States

Presbyterian Healthcare Services

Program Evaluation Healthcare Data Predictive Modeling Data Mining EMR SAS Statistical analysis Business Intelligence Medicare +18

Senior Mid Full Time

USD 124K+

Insurance Claims Representative- Remote
United States

Tenet Healthcare

Remittance review HCFA 1500 Claim Submission UB04 Patient financial services Patient Accounting Insurance collections Managed Care Contracts Call Center Environment +39

Entry Mid Full Time

USD 47K+

Insurance Verification Specialist- Remote
United States

Tenet Healthcare

Remittance review HCFA 1500 Claim Submission Patient financial services UB04 Patient Accounting Insurance collections Managed Care Contracts Call Center Environment +40

Entry Mid Full Time

USD 47K+

Claims and Billing Representative- Remote
United States

Tenet Healthcare

Remittance review Claim Submission HCFA 1500 Patient financial services UB04 Patient Accounting Insurance collections Managed Care Contracts Call Center Environment +38

Entry Mid Full Time

USD 47K+

Sales Contract Management Director - Healthcare
United States

Sales Contract Management EDI Relationships Healthcare operations EDI Healthcare Compliance Functions Events Contract management Contract Negotiation +14

Exec Senior Full Time

USD 156K+

Sales Auditor
Remote-AZ, United States

Centene Corporation

Ambetter Call Center Software HIPAA regulations Tracking Audits Call Center Auditing Medicare Audit +16

USD 77K+

Pre-Authorization Registered Nurse
Remote US, United States

Medical management systems Rehab Medicaid Experience Health Plan Experience Microsoft Office Word Clinical Nursing InterQual MCG Rehabilitation +53

USD 71K+

Value Based Programs Specialty Care Lead
Remote US, United States

Financial leadership VB Healthcare contracting Mathematical modeling Corporate strategy Mathematical Oversight Clinical Experience Interviewing +47

Senior Mid Full Time

USD 104K+

Billing Rep II
Remote, UT, United States

Insurance payer websites Dde Epic Software Medicare billing Durable Medical Equipment Billing Processes Authorizations Hospital billing Intelligent Automation +16

USD 48K+

Staff Vice President, Medicare Trend and Strategy
Remote-MO, United States

Centene Corporation

Medicare cost trend analysis Data-driven care models Clinical vendor management Business process excellence Value-Based Care Models Process excellence Population health management Healthcare operations Health management +32

Senior Full Time

USD 182K+

Patient Financial Clearance Representative I (Remote)
Remote - USA, United States

Stanford Health Care

Healthcare payers Electronic eligibility systems Workers comp Managed care plans Medi-cal Data assessment Authorization processes Financial counseling C-i-care +11

Entry Full Time

USD 75K+

UM Administration Coordinator
Remote US, United States

Computations Microsoft Office Word ICD-10 codes LESS ICD Electronic Medical Records Utilization Review Prior authorization Interviewing +49

USD 40K+

Utilization Management Behavioral Health Professional
Remote US, United States

Interpreting Criteria Microsoft Office Word Social service agencies Health promotion Medical Services LESS Registered Nurse Community Health Utilization Review +51

USD 65K+

Senior SOAR Automation Engineer(remote)
Remote US, United States

Security event triage Cybersecurity frameworks Data Sharing Security principles Security Automation Automation solutions YAML MITRE ATT&CK SOAR +76

Senior Full Time

USD 106K+

Claims Analyst
Remote-CA, United States

Centene Corporation

Revenue Codes Basic math Medical claims ICD-9 HCPCS ICD-10 Training Programs Quality Standards CPT +18

Entry Full Time

USD 30K+

Senior Professional Business Analyst
Any city, WI, US, 99999

Gainwell Technologies

Relational Database Software Re-engineering Computer Programming Programming concepts Process re-engineering Analytical Software Relational database Business Process Re-engineering ALM +37

Senior Full Time

USD 69K+

Claims Escalation Response Specialist IV
Remote-FL, United States

Centene Corporation

Contact center Customer Care Issue Resolution Claims management CMS Claims Medicaid Medicare Health Insurance +15

USD 76K+

Patient Account Senior Representative - Remote
United States

Tenet Healthcare

EOB interpretation Remittance review Team support UB-04 Insurance terminology Claim Submission Patient financial services Patient Accounting Insurance collections +40

Senior Full Time

USD 51K+

Sr. Provider Compliance Specialist (Remote)
Remote - United States

Provider credentialing Workflow Documentation GSheets KPI Analysis NCQA Compliance management Credentialing CMS Cross-functional Teams +11

Senior Mid Full Time

USD 70K+

Supervisor, UM Reporting
United States

Navitus Health Solutions, LLC

Program audits PBM knowledge Data Quality Assurance Prior authorization Utilization management Health Pharmacy Creativity Medicaid +10

Senior Mid Full Time

USD 61K+

Provider Account Manager
Remote-TX, United States

Centene Corporation

Claims billing practices Claims billing Billing practices Provider Relations Commercial Insurance Health Plan Tracking Client Services Claims +24

USD 55K+

Clinical Review Nurse - Concurrent Review
Remote-NY, United States

Centene Corporation

Health management systems Health management Medicaid regulations Guidelines Medical necessity Clinical Review Discharge planning Utilization Acute care +20

USD 95K+

Network Performance Advisor
Remote-FL, United States

Centene Corporation

Risk contracting Utilization metrics Value-based contracting Network transformation Network performance Quality Metrics Network development Cross-functional Communication HEDIS +28

USD 55K+

Home Health Recruiter
Remote US, United States

E-recruiting tools Home Health Registered Nurse Interviewing Staffing RN BI Administrative Healthcare services +33

USD 71K+

IT Internal Auditor 2
Remote US, United States

IT Audit Microsoft Office Applications Internal Audit Control Alteryx Consumer Experiences Efficiency PowerBi Analytics tools +52

Entry Mid Full Time

USD 71K+

Director, Long Term Strategic Planning
Remote US, United States

Passion for excellence Corporate strategy Processes Analyzing Anaplan Detail Orientation Functions Collaborative Business Operations +53

Exec Senior Full Time

USD 184K+

Senior Accreditation Professional
Remote US, United States

NCQA Accreditation Long Term Services and Supports Team Engagement Continuous process improvement Health Plan Experience Functional strategies Long Term Care Judgement LESS +46

Senior Mid Full Time

USD 78K+

Manager, Technology Leadership
Remote US, United States

Hardware delivery Mocking Clinical delivery Product Evaluation Tactical Operations Cross-departmental collaboration Software delivery Metrics Reporting Technical Problem Solving +52

Senior Mid Full Time

USD 117K+

Community Relations Coordinator
Remote-DE, United States

Centene Corporation

Healthcare Programs Community relations Guidelines Community outreach Event Coordination Regulatory Guidelines Health education Health Plan Relationship Development +15

USD 77K+

IT Internal Auditor 1
Remote US, United States

IT Audit Internal Audit Alteryx Efficiency PowerBi Analytics tools PMP Information systems Audits +37

Entry Mid Full Time

USD 59K+

Software Architect - Product Platform
Waterside Bldg, United States

Springwebflux Rules Engines Data Bricks Mongo Application Modernization Digital Platforms Data Streaming Data Lake Health benefits +64

Senior Full Time

USD 106K+

Clinical Review Nurse - Concurrent Review
Remote-CA, United States

Centene Corporation

Health management systems Health management Medicaid regulations Guidelines Clinical Review Medical necessity Discharge planning Utilization Acute care +20

USD 95K+

Associate Director, IT Disaster Recovery
Remote US, United States

IT Disaster Recovery Training and Awareness Programs Disaster recovery planning Business Continuity IT systems IT Infrastructure IT services Disaster Recovery Risk +45

Senior Mid Full Time

USD 129K+

Medical Director - Medicare Grievances and Appeals Corporate
Remote US, United States

General surgery Preservice appeals Health claims Grievances Medical interpretation Hospitalist Family practice Medical background Geriatrics +41

Exec Senior Full Time

USD 246K+

Senior Configuration Professional; Workday Compensation
Remote US, United States

Business Process Configuration Integration Development HR systems Business Process HR technology Interviewing User Experience Design HRIS Integrations +39

Senior Mid Full Time

USD 97K+

Advisor Business Analyst - Shared Services Vermont Medicaid - US remote
Any city, RI, US, 99999

Gainwell Technologies

Requirements Translation Relational Database Software Re-engineering Relational database Process re-engineering Posting Processes Edge Technical Requirements +27

Entry Senior Full Time

USD 86K+

Healthcare Economics Analyst - Remote
Tennessee Work at Home, United States

The Cigna Group

Replication Medical analysis Healthcare metrics Claims Data Healthcare economics Actuarial Analysis Cigna Client-facing Cost Management +42

USD 96K+

Director, Accounts Receivable Collections
United States - Remote

Kestra Medical Technologies, Inc

Operational strategy Customer Experience Management Emotional Intelligence Customer focus Revenue Cycle Management Accounts Receivable Confidentiality Vendor Management Medicare +14

Exec Senior Full Time

USD 185K+

VP, Quality & Performance Outcomes
Dayton WFH, United States

URAC Population health management Healthcare Trends Critical Listening NCQA HEDIS Population health Accreditation Credentialing +31

Exec Senior Full Time

USD 150K+

Senior Learning Facilitation Professional-3
Remote US, United States

Learning material creation Adult Learning Curriculum Design Microsoft Office Applications Adult Learning Principles Articulate Consumer Experiences Healthcare services Care management +35

Senior Full Time

USD 71K+

Senior IT Project Manager
Remote US, United States

Technical Product Selection Information Technology Infrastructure Library Implementation of IT Solutions ASP Ibm db2 CICS Statistical software IT Project Management DB2 +53

Senior Full Time

USD 104K+

Bilingual Call Center Rep (Relationship Coordinator) - Man/Can
Remote - NY, United States

Medicare Eligibility Medicaid Eligibility RightFax Mltcp Paperless database modules MS Office 365 TruCare Telephonic Communication Telemarketing +24

Entry Mid Full Time

USD 41K+

Provider Engagement Network Specialist
Jackson - 111 E Capitol St., Ste 500 (Magnolia) (10106), United States

Centene Corporation

Provider directories Network reporting Demographic information changes Provider information system Contract research Provider data management Medical claims Provider education Claims payment +25

USD 44K+

Medicaid Reporting and Data Analyst
Remote US, United States

Medicaid data Medicaid Reporting Self-Service Tools Qlikview Microsoft Office Applications Microsoft Access Data Warehouse Data Reporting Clinical operations +52

Entry Mid Full Time

USD 60K+

Clinical Review Nurse - Prior Authorization
Remote-CA, United States

Centene Corporation

Service authorization Medical appropriateness Authorization requests Health management systems Clinical reviews Health management Medicaid regulations Guidelines Clinical Information +23

USD 95K+

Market Entry Capture Strategy Lead
Remote US, United States

Managed care operations Delegation Operational expertise Strategy Consulting Operational strategy Healthcare Management Network development Articulate Qualitative Research +71

Senior Mid Full Time

USD 115K+

Lead, Client Operations
Remote

Client operations Health Plan Operations Risk Adjustment Invoicing Client Success Conflict Management Claims management Google Suite Data Entry +10

Senior Mid Full Time

USD 47K+

Enrollment Specialist
Remote, USA, United States

Payer enrollment HIPAA rules and regulations HIPAA Rules Credentialing HIPAA Compliance .Net Data Entry Medicaid Medicare +8

Entry Mid Full Time

USD 45K+

Insurance Specialist (Remote)
Remote - United States

Revenue cycle billing Behavioral health terminology Medigap AdvancedMD Insurance Verification Financial Operations EHR Zendesk Revenue Cycle +11

USD 60K+

CDI Senior Specialist - Remote
United States

Tenet Healthcare

Ms-drg assignment ICD-9-CM Outpatient coding Deductive reasoning MS-DRG Health Information Medical Record Review Coding compliance DRG +32

Senior Full Time

USD 64K+

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