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 ...
Springfield, MA · On-site
$105K - $150K/yr
MassHealth, HSN, Medicare, Medicaid, and Commercial Payer Expertise * Pharmacy Revenue Cycle (Retail & 340B) Oversight * Contracting, Capitation, and Wrap Payment Management * Cross-Functional ...
Springfield, MA · On-site
$105K - $150K/yr
MassHealth, HSN, Medicare, Medicaid, and Commercial Payer Expertise * Pharmacy Revenue Cycle (Retail & 340B) Oversight * Contracting, Capitation, and Wrap Payment Management * Cross-Functional ...
MassHealth, HSN, Medicare, Medicaid, and Commercial Payer Expertise * Pharmacy Revenue Cycle (Retail & 340B) Oversight * Contracting, Capitation, and Wrap Payment Management * Cross-Functional ...
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MassHealth, HSN, Medicare, Medicaid, and Commercial Payer Expertise * Pharmacy Revenue Cycle (Retail & 340B) Oversight * Contracting, Capitation, and Wrap Payment Management * Cross-Functional ...
Bloomfield, CT · On-site
Coordinate Medicare enrollment, supplemental insurance, retirement transitions, and retiree healthcare coverage. * Assist with insurance claims, appeals, and benefits issue resolution. * Support ...
Bloomfield, CT · On-site
Coordinate Medicare enrollment, supplemental insurance, retirement transitions, and retiree healthcare coverage. * Assist with insurance claims, appeals, and benefits issue resolution. * Support ...
We specialize in serving elderly Medicare and Medicaid patients and are committed to helping individuals remain safely in the community after hospitalization. Our agency has achieved: * 98% timely ...
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We specialize in serving elderly Medicare and Medicaid patients and are committed to helping individuals remain safely in the community after hospitalization. Our agency has achieved: * 98% timely ...
Hartford, CT · Remote
$58K - $74K/yr
Responsibilities Prepare, review, and submit electronic and paper claims to Medicare, Medicaid, commercial insurance providers, and other payers. Verify patient insurance eligibility, benefits, and ...
Hartford, CT · Remote
$58K - $74K/yr
Responsibilities Prepare, review, and submit electronic and paper claims to Medicare, Medicaid, commercial insurance providers, and other payers. Verify patient insurance eligibility, benefits, and ...
Hartford, CT · Remote
$58K - $74K/yr
Responsibilities Prepare, review, and submit electronic and paper claims to Medicare, Medicaid, commercial insurance providers, and other payers. Verify patient insurance eligibility, benefits, and ...
Hartford, CT · Remote
$58K - $74K/yr
Responsibilities Prepare, review, and submit electronic and paper claims to Medicare, Medicaid, commercial insurance providers, and other payers. Verify patient insurance eligibility, benefits, and ...
Our Visiting Licensed Practical Nurse for our VNA Certified division provides short- and long-term home care services for patients covered by Medicare, Medicaid, Private Insurance, and Private Pay.
Our Visiting Licensed Practical Nurse for our VNA Certified division provides short- and long-term home care services for patients covered by Medicare, Medicaid, Private Insurance, and Private Pay.
Our Visiting Licensed Practical Nurse for our VNA Certified division provides short- and long-term home care services for patients covered by Medicare, Medicaid, Private Insurance, and Private Pay.
Our Visiting Licensed Practical Nurse for our VNA Certified division provides short- and long-term home care services for patients covered by Medicare, Medicaid, Private Insurance, and Private Pay.
Must have Longterm Care experience including Medicare, Medicaid and other commercial Billing Five Plus Years Experience Required o Demonstrate ability to work within deadlines and prescribed time ...
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Must have Longterm Care experience including Medicare, Medicaid and other commercial Billing Five Plus Years Experience Required o Demonstrate ability to work within deadlines and prescribed time ...
Suffield, CT · On-site
$40 - $45/hr
... Medicare Meeting and communicates pertinent MDS information. 10. Reviews each Medicare resident for appropriateness of Medicare coverage. 11. Obtains monthly Quality Indicator Reports and provides ...
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Suffield, CT · On-site
$40 - $45/hr
... Medicare Meeting and communicates pertinent MDS information. 10. Reviews each Medicare resident for appropriateness of Medicare coverage. 11. Obtains monthly Quality Indicator Reports and provides ...
Must have Longterm Care experience including Medicare, Medicaid and other commercial Billing Five Plus Years Experience Required o Demonstrate ability to work within deadlines and prescribed time ...
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Must have Longterm Care experience including Medicare, Medicaid and other commercial Billing Five Plus Years Experience Required o Demonstrate ability to work within deadlines and prescribed time ...
Holyoke, MA · Remote
$26.44/hr
Extensive knowledge of Medicare, Medicaid, managed care networks and insurance carriers required. * Extensive knowledge of accounts receivable functions including CPT and ICD-10 coding required.
Holyoke, MA · Remote
$26.44/hr
Extensive knowledge of Medicare, Medicaid, managed care networks and insurance carriers required. * Extensive knowledge of accounts receivable functions including CPT and ICD-10 coding required.
$15.25 - $19.75/hr
Support the Medicaid and Medicare application and billing processes. * Assist with resident trust funds and petty cash management. * Maintain accurate resident financial files and documentation.
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$15.25 - $19.75/hr
Support the Medicaid and Medicare application and billing processes. * Assist with resident trust funds and petty cash management. * Maintain accurate resident financial files and documentation.
$40 - $45/hr
Our Visiting Registered Nurse (VNA) Certified division provides short- and long-term home care services for patients covered by Medicare, Medicaid, Private Insurance, and Private Pay. Services ...
$40 - $45/hr
Our Visiting Registered Nurse (VNA) Certified division provides short- and long-term home care services for patients covered by Medicare, Medicaid, Private Insurance, and Private Pay. Services ...
Our Visiting Registered Nurse (VNA) Certified division provides short- and long-term home care services for patients covered by Medicare, Medicaid, Private Insurance, and Private Pay. Services ...
Our Visiting Registered Nurse (VNA) Certified division provides short- and long-term home care services for patients covered by Medicare, Medicaid, Private Insurance, and Private Pay. Services ...
Our Visiting Registered Nurse (VNA) Certified division provides short- and long-term home care services for patients covered by Medicare, Medicaid, Private Insurance, and Private Pay. Services ...
Our Visiting Registered Nurse (VNA) Certified division provides short- and long-term home care services for patients covered by Medicare, Medicaid, Private Insurance, and Private Pay. Services ...
$40 - $45/hr
Our Visiting Registered Nurse (VNA) Certified division provides short- and long-term home care services for patients covered by Medicare, Medicaid, Private Insurance, and Private Pay. Services ...
$40 - $45/hr
Our Visiting Registered Nurse (VNA) Certified division provides short- and long-term home care services for patients covered by Medicare, Medicaid, Private Insurance, and Private Pay. Services ...
Hartford, CT · On-site
$55 - $60/hr
Familiarity with Snowflake Cortex or similar AI/ML platforms. * Healthcare domain knowledge (Medicare STARS a plus). * Proficiency in Python or SQL for data interaction. Responsibilities: * Design ...
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Hartford, CT · On-site
$55 - $60/hr
Familiarity with Snowflake Cortex or similar AI/ML platforms. * Healthcare domain knowledge (Medicare STARS a plus). * Proficiency in Python or SQL for data interaction. Responsibilities: * Design ...
$14.61 - $17.57
4% of jobs
$20.23 is the 25th percentile. Wages below this are outliers.
$17.57 - $20.54
23% of jobs
$20.54 - $23.50
12% of jobs
The median wage is $25.13 / hr.
$23.50 - $26.46
20% of jobs
$28.20 is the 75th percentile. Wages above this are outliers.
$26.46 - $29.42
27% of jobs
$29.42 - $32.38
9% of jobs
$32.38 - $35.34
0% of jobs
$35.34 - $38.31
0% of jobs
$38.31 - $41.27
0% of jobs
$41.27 - $44.23
2% of jobs
$44.23 - $47.19
2% of jobs
$14
$26
$47
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.
$140K - $155K/yr
Other
Medical, Dental, Vision, Life, Retirement, PTO
Re-posted 6 days ago
6.8
Based on 30 frontline employees who took The Breakroom Quiz
47th of 239 rated social care providers
Balance Life & Work with a New Career Opportunity
(LONG TERM CARE)
(SHORT TERM REHAB)
(SKILLED NURSING)
(SUB ACUTE CARE)
NOW HIRING!! Regional Clinical Reimbursement Specialist Western/Central MA
Salary
$140,000. - $155,000 annually
Compensation will be based on, but not limited to, experience, qualifications, credentials and any other relevant information
The Regional Clinical Reimbursement Specialist/MDS plays a crucial role in ensuring the accurate and timely completion of the Minimum Data Set (MDS) assessments for residents in long-term care facilities. This position requires a keen understanding of medical records, clinical, documentation, and compliance with healthcare standards.
The RCRS will be responsible for regularly visiting up to 3-4 CareOne facilities as assigned based on geography.
Position Requirements:
Ideal candidates will possess the following:
The CareOne mission is to define excellence within the health care community. We are dedicated to Maximizing Patient Outcomes. We treat Residents, their families and each other with respect, dignity and compassion. Through a collaborative and consultative approach, we strive to provide a framework of strength and stability for our Centers and Communities. We work to maintain the highest standards of care and service for Residents, families and our valued employees.
We are proud to Offer the following benefits to Part-time (22.5+ hours/week) and Full-time Employees:
If working with people who are dedicated, compassionate, and concerned about their patients is essential to you, then you'll appreciate being a part of our team. We've built a strong reputation on the outstanding level of care that we provide. We have a graciously appointed facility with strong belief in patient care and service; join us at our beautiful facility!
We are an Equal Opportunity Employer
EEO/AA/M/F/DV
Sourced by ZipRecruiter
CareOne is a leading healthcare corporation specializing in senior care, rehabilitation, and assisted living services. Based in Fort Lee, New Jersey, CareOne was established to meet the healthcare requirements of seniors across the state and has expanded its footprint over the years. With its dedication to excellence, CareOne provides a comprehensive range of medical and healthcare services, including post-acute care, long-term and assisted living, memory care, respite care, and more.
Health care and social assistance
10,000+ Employees
Fort Lee, NJ, US
1999
