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Accurately apply the Eligibility Policies and Procedures to determine client eligibility and enroll eligible clients into the appropriate local and grant programs, and assist clients with submitting applications for state and federal health coverage programs. Under general supervision, this role combines eligibility determination, financial screening, application assistance and enrollment services for local, state, and federally funded healthcare programs.

TRAVIS COUNTY HEALTHCARE DISTRICT

Eligibility and Financial Screening Specialist (Special Populations Working with Individuals Experiencing Homelessness)

Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of responses per state, federal and Molina guidelines. Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related outside agencies to ensure that internal and/or regulatory timelines are met.

Molina Healthcare Inc

Specialist, Appeals & Grievances (Must live in TX and Medicaid experience)

Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of responses per state, federal and Molina guidelines. Prepares draft narratives, graphs, flowcharts, etc. for use in presentations and audits; researches claims appeals and grievances using support systems to determine appeals and grievances outcomes.

Lead Specialist, Appeals & Grievances

The Billing Contractor supports recurring billing operations across the organization, with a primary focus on accounts receivable, collections follow-up, subscription billing administration, and related invoicing tasks. The ideal candidate is highly organized, comfortable communicating directly with clients about payment matters, and able to learn and work across multiple software systems.

HOUR

TogetherWork

Billing Specialist

GreenHouseAPI

ARCHER Systems is a leading technology-enabled legal services company that provides pre-settlement and post-settlement administration services for a single event, mass tort, and class action cases with the goal of helping claimants access their settlement proceeds more efficiently and quickly. ARCHER’s core offering is post-settlement Healthcare Lien Resolution Administration and QSF (Qualified Settlement Fund) Administration and payments processing for multi-claimant (mass tort and class action) litigation.

ARCHER Systems

Lien Resolution Specialist

Our Job Corps programs provide life-changing services that help young people succeed in school, obtain good jobs, excel in their chosen fields, and serve as contributing members of their communities. A minimum of an Associate's degree in human services, psychology, counseling, education, social science, communications, or closely related field, and two years related experience.

Arbor E&T, LLC

Community Outreach & Enrollment Specialist (930946)

This is an entry level position responsible for processing all release of information (ROI), specifically medical record requests, in a timely and efficient manner ensuring accuracy and providing customers with the highest quality product and customer service. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies.

Datavant LLC

Health Information Specialist I

You'll attend our award-winning training program and join a sales team that works with both new and existing clients to sell human resources solutions, making employees' lives better with high-quality benefits offerings across the hire-to-retire spectrum. Deepen Relationships Across the ADP Family: In addition to cloud-based human resources solutions, you will strategically cross-sell with other ADP associates to cultivate additional business within existing accounts; you will make life-long friendships here.

ADP powers the working world with comprehensive solutions that drive business success. Consistently named one of the "Most Admired Companies" by FORTUNE® Magazine, and recognized by Forbes® as one of "The World's Most Innovative Companies," ADP has over a half-million clients around the globe and 65 years of experience as one of the largest providers of human capital management solutions world-wide.


At ADP, we believe that diversity fuels innovation. ADP is committed to equal employment opportunities regardless of race, color, genetic information, creed, religion, sex, sexual orientation, gender identity, lawful alien status, national origin, age, marital status, non-job related physical or mental disability, or protected veteran status. We support an inclusive workplace where associates excel based on personal merit, qualifications, experience, ability, and job performance.

Tool Designer Jobs in Waltham, MA

Eligibility and Financial Screening Specialist (Special Populations Working with Individuals Experiencing Homelessness) TRAVIS COUNTY HEALTHCARE DISTRICT

Specialist, Appeals & Grievances (Must live in TX and Medicaid experience) Molina Healthcare Inc

Lead Specialist, Appeals & Grievances Molina Healthcare Inc

Billing Specialist TogetherWork

Lien Resolution Specialist ARCHER Systems

Community Outreach & Enrollment Specialist (930946) Arbor E&T, LLC

Health Information Specialist I Datavant LLC

HRO Total Source - Strategic Sales Specialist Automatic Data Processing Inc

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