Hartford, CT · On-site
$46K - $102K/yr
Monitor and audit as outlined in Medicare Compliance Work Plan and direct other projects as assigned to evaluate compliance, propose remediation where necessary and monitor implementation of ...
Hartford, CT · On-site
$46K - $102K/yr
Monitor and audit as outlined in Medicare Compliance Work Plan and direct other projects as assigned to evaluate compliance, propose remediation where necessary and monitor implementation of ...
Health Payer Technology Medicare Consultant Job Level: Senior Level THIS IS WHAT YOU WILL DO... You will be adapting existing methods and procedure to create possible alternative solutions to ...
Health Payer Technology Medicare Consultant Job Level: Senior Level THIS IS WHAT YOU WILL DO... You will be adapting existing methods and procedure to create possible alternative solutions to ...
Hartford, CT · On-site
$67K - $182K/yr
Position Summary As the Senior Manager, Medicare Product Implementation, you will lead the end-to-end implementation and operational execution of assigned Medicare Advantage programs in coordination ...
Hartford, CT · On-site
$67K - $182K/yr
Position Summary As the Senior Manager, Medicare Product Implementation, you will lead the end-to-end implementation and operational execution of assigned Medicare Advantage programs in coordination ...
Hartford, CT · On-site
$82K - $182K/yr
Asa Senior Manager Business Compliance (Medicare) you will play a critical role by leading and delivering complex compliance initiatives that support regulatory adherence and operational excellence.
Hartford, CT · On-site
$82K - $182K/yr
Asa Senior Manager Business Compliance (Medicare) you will play a critical role by leading and delivering complex compliance initiatives that support regulatory adherence and operational excellence.
Hartford, CT · Remote
$25/hr
Description REMOTE Medicare TeleSales SHIFT: Monday - Friday between hours of 8am - 5:30, with some weekends. QUALIFICATIONS: Current Health Insurance license required; NY appointment required or ...
Hartford, CT · Remote
$25/hr
Description REMOTE Medicare TeleSales SHIFT: Monday - Friday between hours of 8am - 5:30, with some weekends. QUALIFICATIONS: Current Health Insurance license required; NY appointment required or ...
Holyoke, MA · Remote
$23 - $28/hr
You are responsible for professional CPT coding for Medicare and Medicare like payers. * You will abstract all data elements into the WellSky EMR platform * You will use the TruBridge encoder ...
New
Holyoke, MA · Remote
$23 - $28/hr
You are responsible for professional CPT coding for Medicare and Medicare like payers. * You will abstract all data elements into the WellSky EMR platform * You will use the TruBridge encoder ...
New
Holyoke, MA · Remote
$18.50 - $24.50/hr
You are responsible for professional CPT coding for Medicare and Medicare like payers. * You will abstract all data elements into the WellSky EMR platform * You will use the TruBridge encoder ...
New
Holyoke, MA · Remote
$18.50 - $24.50/hr
You are responsible for professional CPT coding for Medicare and Medicare like payers. * You will abstract all data elements into the WellSky EMR platform * You will use the TruBridge encoder ...
New
Holyoke, MA · On-site
$18.50 - $24.50/hr
You are responsible for professional CPT coding for Medicare and Medicare like payers. * You will abstract all data elements into the WellSky EMR platform * You will use the TruBridge encoder ...
New
Holyoke, MA · On-site
$18.50 - $24.50/hr
You are responsible for professional CPT coding for Medicare and Medicare like payers. * You will abstract all data elements into the WellSky EMR platform * You will use the TruBridge encoder ...
New
$33 - $42.25/hr
Completion of the 100 day Medicare Part A and Managed Care Log * Completion of the Weekly Medicare Part A/Managed Care and RUG-IV 48 Report * Completion of RUG-IV 48 supporting documentation Audit ...
Quick apply
$33 - $42.25/hr
Completion of the 100 day Medicare Part A and Managed Care Log * Completion of the Weekly Medicare Part A/Managed Care and RUG-IV 48 Report * Completion of RUG-IV 48 supporting documentation Audit ...
$33 - $42.25/hr
Completion of the 100 day Medicare Part A and Managed Care Log * Completion of the Weekly Medicare Part A/Managed Care and RUG-IV 48 Report * Completion of RUG-IV 48 supporting documentation Audit ...
Quick apply
$33 - $42.25/hr
Completion of the 100 day Medicare Part A and Managed Care Log * Completion of the Weekly Medicare Part A/Managed Care and RUG-IV 48 Report * Completion of RUG-IV 48 supporting documentation Audit ...
$140K - $155K/yr
Implement and direct Medicare and Medicaid auditing and systems review. * Admission pre-screening review * Admission documentation requirement review * Financial documentation requirement review
Quick apply
$140K - $155K/yr
Implement and direct Medicare and Medicaid auditing and systems review. * Admission pre-screening review * Admission documentation requirement review * Financial documentation requirement review
Responsibilities: • Oversee and manage facility A/R, resident trust accounts, general ledger and A/P • Ensure proper Medicare/Medicaid billing • Supervise Business office staff Qualifications ...
Quick apply
Responsibilities: • Oversee and manage facility A/R, resident trust accounts, general ledger and A/P • Ensure proper Medicare/Medicaid billing • Supervise Business office staff Qualifications ...
Responsibilities: • Oversee and manage facility A/R, resident trust accounts, general ledger and A/P • Ensure proper Medicare/Medicaid billing • Supervise Business office staff Qualifications ...
Quick apply
Responsibilities: • Oversee and manage facility A/R, resident trust accounts, general ledger and A/P • Ensure proper Medicare/Medicaid billing • Supervise Business office staff Qualifications ...
$70K - $85K/yr
Responsibilities: • Oversee and manage facility A/R, resident trust accounts, general ledger and A/P • Ensure proper Medicare/Medicaid billing • Supervise Business office staff Qualifications ...
Quick apply
$70K - $85K/yr
Responsibilities: • Oversee and manage facility A/R, resident trust accounts, general ledger and A/P • Ensure proper Medicare/Medicaid billing • Supervise Business office staff Qualifications ...
Implement and direct Medicare and Medicaid auditing and systems review. * Admission pre-screening review * Admission documentation requirement review * Financial documentation requirement review
Quick apply
Implement and direct Medicare and Medicaid auditing and systems review. * Admission pre-screening review * Admission documentation requirement review * Financial documentation requirement review
Implement and direct Medicare and Medicaid auditing and systems review. * Admission pre-screening review * Admission documentation requirement review * Financial documentation requirement review
Quick apply
Implement and direct Medicare and Medicaid auditing and systems review. * Admission pre-screening review * Admission documentation requirement review * Financial documentation requirement review
MassHealth, HSN, Medicare, Medicaid, and Commercial Payer Expertise * Pharmacy Revenue Cycle (Retail & 340B) Oversight * Contracting, Capitation, and Wrap Payment Management * Cross-Functional ...
New
Quick apply
MassHealth, HSN, Medicare, Medicaid, and Commercial Payer Expertise * Pharmacy Revenue Cycle (Retail & 340B) Oversight * Contracting, Capitation, and Wrap Payment Management * Cross-Functional ...
New
Northampton, MA · On-site
$140K - $155K/yr
Audit the completion and accuracy of MDS's and Care Plans per schedule as required for Medicare, Managed care and OBRA schedules * Ensure compliance with State, Federal, and SimpleLTC transmissions ...
Northampton, MA · On-site
$140K - $155K/yr
Audit the completion and accuracy of MDS's and Care Plans per schedule as required for Medicare, Managed care and OBRA schedules * Ensure compliance with State, Federal, and SimpleLTC transmissions ...
$140K - $155K/yr
Audit the completion and accuracy of MDS's and Care Plans per schedule as required for Medicare, Managed care and OBRA schedules * Ensure compliance with State, Federal, and SimpleLTC transmissions ...
$140K - $155K/yr
Audit the completion and accuracy of MDS's and Care Plans per schedule as required for Medicare, Managed care and OBRA schedules * Ensure compliance with State, Federal, and SimpleLTC transmissions ...
$140K - $155K/yr
Audit the completion and accuracy of MDS's and Care Plans per schedule as required for Medicare, Managed care and OBRA schedules * Ensure compliance with State, Federal, and SimpleLTC transmissions ...
$140K - $155K/yr
Audit the completion and accuracy of MDS's and Care Plans per schedule as required for Medicare, Managed care and OBRA schedules * Ensure compliance with State, Federal, and SimpleLTC transmissions ...
$14.27 - $17.16
4% of jobs
$19.76 is the 25th percentile. Wages below this are outliers.
$17.16 - $20.06
23% of jobs
$20.06 - $22.95
12% of jobs
The median wage is $24.55 / hr.
$22.95 - $25.84
20% of jobs
$27.54 is the 75th percentile. Wages above this are outliers.
$25.84 - $28.73
27% of jobs
$28.73 - $31.63
9% of jobs
$31.63 - $34.52
0% of jobs
$34.52 - $37.41
0% of jobs
$37.41 - $40.31
0% of jobs
$40.31 - $43.20
2% of jobs
$43.20 - $46.09
2% of jobs
$14
$26
$46
Medicare Specialists often encounter challenges related to keeping up with frequently changing regulations and managing complex claims issues. Staying current with updates requires ongoing training and close attention to industry bulletins. Handling denials or appeals can be demanding, but most teams provide collaborative support and access to resources for resolving difficult cases. Effective time management and clear communication with both beneficiaries and healthcare providers help streamline processes and ensure compliance. Many organizations also offer opportunities for skill development to help specialists adapt to evolving policies.
A Medicare job typically involves working with the federal health insurance program that provides coverage for seniors and certain individuals with disabilities. Roles in this field can include customer service representatives, claims processors, billing specialists, and Medicare advisors. Responsibilities often include helping beneficiaries understand their coverage, processing claims, ensuring compliance with regulations, and assisting with enrollment. Many Medicare jobs are found in healthcare companies, government agencies, or insurance providers.
To thrive in a Medicare Specialist role, a deep understanding of Medicare regulations, claims processing, and health insurance fundamentals is essential, often requiring a background in healthcare administration or a related field. Familiarity with billing software, claims adjudication systems, and relevant certifications such as Certified Medical Reimbursement Specialist (CMRS) are highly valuable. Strong attention to detail, analytical thinking, and effective communication skills help distinguish top performers. These competencies ensure accurate claim handling, regulatory compliance, and positive interactions with providers and beneficiaries.
$46K - $102K/yr
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 5 hours ago
5.8
Based on 4,281 frontline employees who took The Breakroom Quiz
81st of 104 rated pharmacies
We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.
Position Summary
The Senior Analyst is a compliance position that applies compliance, regulatory, business, analytical and communication skills to support, manage and develop and execute Medicare compliance programs and processes that promote compliant and ethical behavior, meet regulatory obligations, and prevent, detect and mitigate compliance risks. The individual will work independently, as well as collaboratively, with internal senior level corporate compliance and business teams that operate Medicare Advantage in a highly complex regulatory environment and highly matrixed organization environment with a current focus on integrated special needs plans.
The analyst maintain productive relationships and open lines of communication with internal and key external stakeholders to effectively communicate and influence compliant outcomes and ensure that processes are enhanced or implemented to effectively address compliance requirements.
Responsibilities include, but are not limited to:
Lead and implement an effective Compliance Program as described in CMS Medicare Managed Care Manuals/regulations, including risk assessment, auditing and monitoring and corrective action oversight.
Develop and manage compliance strategies, programs, and processes that promote compliant and ethical behavior, meet regulatory obligations, and prevent, detect, and mitigate compliance risks.
Track, analyze, and work open issue in a timely manner
Maintain in-depth working knowledge and expertise in Medicare regulations
Builds and maintains positive relationships at senior levels to drive decision-making and influence ethical and compliant outcomes
Monitor and audit as outlined in Medicare Compliance Work Plan and direct other projects as assigned to evaluate compliance, propose remediation where necessary and monitor implementation of corrective action
Support broader compliance initiatives and needs as assigned to ensure that effective compliance programs are achieved and maintained.
Other duties as assigned.
In order to be successful in this role you must exhibit the following: -
-Extensive knowledge of Medicare compliance programs and rules
-Experience in validation, auditing and monitoring, root cause analysis and corrective action oversight
-Outstanding time management and project management
-Proficient in utilization of information systems
-Adept at execution and delivery (planning, delivering, and supporting) skills
-Adept at collaboration and teamwork
Required Qualifications
2+ years' experience in Medicare Compliance or regulatory work
Willingness to travel up to 10% (including by plane)
Preferred Qualifications
Understand Medicare Requirements
3+ years of Medicare Compliance work
Education
Bachelor's Degree; equivalent work experience may substituate.
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$46,988.00 - $102,000.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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Health care and social assistance and retail
10,000+ Employees
Woonsocket, RI, US
